Anti-inflammatory effects of insulin.
OBJECTIVE
This review deals with the recent observations on the pro-inflammatory effects of glucose and the anti-inflammatory actions of insulin. Apart from being novel, they are central to our understanding of why hyperglycemia is a prognosticator of bad clinical outcomes including patients with acute coronary syndromes, stroke and in patients in the intensive care unit.


RESULTS
The pro-inflammatory effect of glucose as well as that of other macronutrients including fast food meals provides the basis of chronic oxidative stress and inflammation in the obese and their propensity to atherosclerotic disease. The anti-inflammatory action of insulin provides a neutralizing effect to balance macronutrient induced inflammation on the one hand and the possibility of using insulin as an anti-inflammatory drug on the other.


CONCLUSIONS
The actions of macronutrients and insulin described above explain why insulin resistant states like obesity and type 2 diabetes are associated with oxidative stress, inflammation and atherosclerosis. They also suggest that insulin may be antiatherogenic.
Dandona
Paresh
P
Division of Endocrinology, Diabetes and Metabolism, State University of New York at Buffalo, Buffalo, New York 14209, USA. pdandona@KaleidaHealth.org
Chaudhuri
Ajay
A
Mohanty
Priya
P
Ghanim
Husam
H
D005947:Glucose / Q000009:adverse effects* / Q000378:metabolism; D006801:Humans; D006943:Hyperglycemia / Q000150:complications / Q000378:metabolism; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D007249:Inflammation / Q000139:chemically induced / Q000517:prevention & control; D007328:Insulin / Q000502:physiology / Q000627:therapeutic use*; D009765:Obesity / Q000378:metabolism / Q000503:physiopathology*; D018384:Oxidative Stress
D007004:Hypoglycemic Agents; D007328:Insulin; D005947:Glucose