title: [Insulin treatment is of value--also in type 2 diabetes].
abstract: Consensus has not been reached about the optimal treatment of type 2 diabetes, and several authors have questioned the use of insulin for this disorder. The reasons are that an association has been found between hyperinsulinaemia and cardiovascular disease in non-diabetic men, and the sparse evidence of a beneficial effect from tight glycaemic control in prevention of late complications in type 2 diabetes. We discuss the pathophysiology of atherosclerosis in type 2 diabetes, and review some of the recent literature. We find it likely that, in the metabolic cardiovascular syndrome found in many patients with type 2 diabetes, insulin resistance is more important than the accompanying hyperinsulinaemia. Furthermore, evidence is emerging of a strong association between hyperglycaemia and atherosclerotic vascular disease in patients with type 2 diabetes. We conclude that insulin treatment should be used in type 2 diabetic patients when the hyperglycaemia cannot be controlled by oral agents.
authors.affiliation: Endokrinologisk avdeling, Medisinsk klinikk, Aker sykehus, Oslo.
authors.forename: K I
authors.initials: KI
authors.lastname: Birkeland
authors.forename: S
authors.initials: S
authors.lastname: Vaaler
authors.forename: K F
authors.initials: KF
authors.lastname: Hanssen
mesh_terms: D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D006801:Humans; D007328:Insulin / Q000008:administration & dosage* / Q000097:blood; D007333:Insulin Resistance; D012307:Risk Factors
chemical_list: D007328:Insulin
vernacular_title: Insulinbehandling er nyttig--også ved type 2-diabetes.