Insulin as an anti-inflammatory and antiatherogenic modulator.
Data demonstrate the anti-inflammatory effects of insulin and proinflammatory effects of glucose. These data provide a mechanistic justification for the benefits of maintaining euglycemia with insulin infusions in hospitalized patients. Regimens that infuse fixed doses of insulin with high rates of glucose are usually associated with hyperglycemia, which may neutralize the beneficial effects of insulin. Therefore, we propose that such regimens should be avoided and instead replaced by insulin infusions that normalize and maintain blood glucose at a reasonably low level and ensure that plasma insulin is maintained at levels high enough to provide clinically relevant anti-inflammatory and cardioprotective effects. Trials to test this hypothesis are in progress.
Dandona
Paresh
P
Kaleida Health, Buffalo, New York, USA. pdandona@kaleidahealth.org
Chaudhuri
Ajay
A
Ghanim
Husam
H
Mohanty
Priya
P
D054058:Acute Coronary Syndrome / Q000209:etiology / Q000517:prevention & control*; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D000924:Anticholesteremic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D001786:Blood Glucose / Q000187:drug effects*; D048909:Diabetes Complications / Q000517:prevention & control*; D003920:Diabetes Mellitus / Q000188:drug therapy*; D006801:Humans; D006943:Hyperglycemia / Q000188:drug therapy*; D007004:Hypoglycemic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D007249:Inflammation / Q000209:etiology / Q000517:prevention & control; D007262:Infusions, Intravenous; D007328:Insulin / Q000097:blood / Q000627:therapeutic use*; D018384:Oxidative Stress
D000893:Anti-Inflammatory Agents; D000924:Anticholesteremic Agents; D001786:Blood Glucose; D007004:Hypoglycemic Agents; D007328:Insulin