title: Blood pressure reactions to insulin treatment in patients with type 2 diabetes.
abstract: BACKGROUND
  The initiation of insulin therapy may be easy and uncomplicated in some patients with type 2 diabetes, but in others, mainly in obese patients, problems often arise (ie, poor compliance, worsening B-cell function and/or insulin resistance).
  
  
  METHODS
  As a substudy of a broader investigation concerning hemorheological effects of insulin treatment in insufficiently controlled type 2 diabetes, blood pressure was recorded in 12 patients at baseline, after two months and after four months on insulin.
  
  
  RESULTS
  After two months on insulin, analyses of triglycerides, high-density lipoprotein cholesterol and total cholesterol indicated metabolic improvement (P<0.05 to 0.001) and a surprisingly uniform increase of blood pressure values (P<0.05 to 0.01) was found. At the same time, the serum sodium concentration increased (P<0.01) and was positively correlated to both systolic and diastolic blood pressure (P<0.01). After four months on insulin, blood pressure returned to pretreatment values or lower (P<0.05 to 0.01). Serum sodium also decreased to pretreatment values. No significant changes of the flow behaviour of blood were seen after the initiation of insulin.
  
  
  CONCLUSIONS
  The number of patients was small and the study was not primarily designed to examine blood pressure. The preliminary conclusion from the present study, however, is that the initiation of insulin treatment in poorly controlled type 2 diabetes causes a temporary and possibly clinically significant elevation of blood pressure. A change in renal treatment of sodium caused by insulin may be one of several possible explanations of the results, but further studies are warranted to confirm the findings.
authors.affiliation: Department of Clinical Physiology, County Hospital; School of Health Sciences and Social Work, Växjö University, Växjö, Sweden.
authors.forename: Sylvi U
authors.initials: SU
authors.lastname: Persson