Arteriosclerosis, Thrombosis, and Vascular Biology. 2000;20:545-550
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© 2000 American Heart Association, Inc.
Atherosclerosis and Lipoproteins |
Insulin Therapy Improves Endothelial Function in Type 2 Diabetes
From the Department of Medicine, Division of Endocrinology and Diabetology, Helsinki, Finland.
Correspondence to Hannele Yki-Järvinen, MD, University of Helsinki, Department of Medicine, PO Box 340, 00029 HUCH, Helsinki, Finland. E-mail ykijarvi{at}helsinki.fi
Abstract—A total of 75 in vivo endothelial function tests (intrabrachial artery infusions of endothelium-dependent [acetylcholine] and -independent [sodium nitroprusside] vasoactive agents) were performed in 18 type 2 diabetic patients (aged 58±2 years, body mass index 28.5±0.6 kg/m2, and fasting plasma glucose 229±11 mg/dL) and 27 matched normal subjects. These tests were performed before and 6 months after combination therapy with insulin and metformin and before and 6 months after metformin therapy only. Before insulin therapy, blood flow responses to acetylcholine (15 µg/min) were significantly blunted in type 2 diabetic patients (7.5±0.7 mL · dL-1 · min-1) compared with normal subjects (11.6±0.9 mL · dL-1 · min-1, P<0.01). During insulin therapy, the acetylcholine response increased by 44% to 10.8±1.6 mL · dL-1 · min-1 (P<0.05). Insulin therapy also significantly increased the blood flow responses to both low and high doses of sodium nitroprusside. We conclude that insulin therapy improves endothelium-dependent and -independent vasodilatation. These data support the idea that insulin therapy has beneficial rather than harmful effects on vascular function.
Key Words: endothelium • atherosclerosis • vasodilatation • insulin therapy • type 2 diabetes
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