Insulin therapy--role beyond glucose control.
Larger studies had shown improved patient outcome and lower probability of coronary artery disease in insulin treated groups. The classical lipid abnormalities associated with type 2 diabetes are low HDL-cholesterol concentration and high triglyceride concentration. Insulin usage leads to a decrease in triglyceride concentration, primarily by its effect on the enzyme adipose tissue lipoprotein lipase. Insulin suppresses the enzyme, thereby controlling lipolysis in uncontrolled diabetes. Insulins therapy also improves the endothelial dysfunction especially in people with evident macrovascular complications. Though insulin is noted to increase adrenergic tone and may cause elevation of blood pressure, still patients with insulinoma do not have high blood pressure. Some studies suggest weight gain with insulin therapy, others contradict it. One study suggests that insulin does not affect treatment satisfaction. Insulin is known to improve the glycaemic scenario and also the insulin secretory pattern by reducing the glucotoxicity.
Pandit
Kaushik
K
Wockhardt Hospitals, Kolkata 700020.
Mukhopadhyay
Pradip
P
D000544:Alzheimer Disease / Q000188:drug therapy; D001786:Blood Glucose / Q000187:drug effects / Q000378:metabolism; D008076:Cholesterol, HDL / Q000097:blood / Q000187:drug effects / Q000378:metabolism; D008078:Cholesterol, LDL / Q000097:blood / Q000187:drug effects / Q000378:metabolism; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000188:drug therapy*; D016640:Diabetes, Gestational / Q000188:drug therapy; D004727:Endothelium / Q000187:drug effects / Q000378:metabolism; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000378:metabolism / Q000494:pharmacology / Q000627:therapeutic use*; D007328:Insulin / Q000378:metabolism / Q000494:pharmacology / Q000627:therapeutic use*; D008074:Lipoproteins / Q000097:blood / Q000187:drug effects / Q000378:metabolism; D008569:Memory Disorders / Q000188:drug therapy; D011247:Pregnancy; D011379:Prognosis; D018805:Sepsis / Q000188:drug therapy; D016896:Treatment Outcome
D001786:Blood Glucose; D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D007004:Hypoglycemic Agents; D007328:Insulin; D008074:Lipoproteins