Abstract
Background: Since insulin therapy might have an atherogenic effect, we studied the relationship between cumulative insulin dose and atherosclerosis in type 1 diabetes. We have focused on patients with type 1 diabetes instead of type 2 diabetes to minimise the effect of insulin resistance as a potential confounder.
Methods: An observational study was performed in 215 subjects with type 1 diabetes treated with multiple insulin injection therapy. Atherosclerosis was assessed by measurement of carotid intima-media thickness (CIMT).
Results: The cumulative dose of regular insulin showed a positive and significant relation with CIMT: increase of 21 mu m in CIMT per S.D. of insulin use (95% CI: 8-35 adjusted for gender and age), which remained unchanged after adjustment for duration of diabetes, HbA1c, BMI, pulse pressure. physical activity and carotid lumen diameter. A similar relation was found for intermediate-acting insulin: 15.5 mu m per S.D. (2-29), which was no longer present after further adjustment.
Conclusions: These findings provide evidence that a high cumulative dose of regular insulin is a risk factor for atherosclerosis. (c) 2005 Elsevier Ireland Ltd. All rights reserved.
| Original language | English |
|---|---|
| Pages (from-to) | 185-192 |
| Number of pages | 8 |
| Journal | ATHEROSCLEROSIS |
| Volume | 181 |
| Issue number | 1 |
| DOIs | |
| Publication status | Published - Jul-2005 |
Keywords
- type 1 diabetes
- carotid arterial wall thickness
- insulin
- insulin resistance
- insulin injections
- INTIMA-MEDIA THICKNESS
- CORONARY-HEART-DISEASE
- AORTIC ENDOTHELIAL-CELLS
- ARTERIAL-WALL THICKNESS
- CAROTID ATHEROSCLEROSIS
- CARDIOVASCULAR-DISEASE
- NITRIC-OXIDE
- MACROVASCULAR DISEASE
- MYOCARDIAL-INFARCTION
- FEASIBILITY TRIAL