© 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
This article has been cited by other articles:
 |
|
 |
|
  S. Dickinson, D. P Hancock, P. Petocz, A. Ceriello, and J. Brand-Miller High-glycemic index carbohydrate increases nuclear factor-{kappa}B activation in mononuclear cells of young, lean healthy subjects Am. J. Clinical Nutrition, May 1, 2008; 87(5): 1188 - 1193. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. Chamberlain Anyone Have a Pen? DOC News, September 1, 2007; 4(9): 3 - 3. [Full Text]
|
|
|
|
 |
|
 E. Gkaliagkousi, A. Shah, and A. Ferro Review: Pharmacological and non-pharmacological treatment of endothelial dysfunction: relevance to diabetes The British Journal of Diabetes & Vascular Disease, January 1, 2007; 7(1): 5 - 10. [Abstract] [PDF]
|
|
|
|
 |
|
 T. S. Hermann, W. Li, H. Dominguez, N. Ihlemann, C. Rask-Madsen, A. Major-Pedersen, D. B. Nielsen, K. W. Hansen, M. Hawkins, L. Kober, et al. Quinapril Treatment Increases Insulin-Stimulated Endothelial Function and Adiponectin Gene Expression in Patients with Type 2 Diabetes J. Clin. Endocrinol. Metab., March 1, 2006; 91(3): 1001 - 1008. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S Jadhav, J Petrie, W Ferrell, S Cobbe, and N Sattar Insulin resistance as a contributor to myocardial ischaemia independent of obstructive coronary atheroma: a role for insulin sensitisation? Heart, December 1, 2004; 90(12): 1379 - 1383. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. B. Wheatcroft, A. M. Shah, J.-M. Li, E. Duncan, B. T. Noronha, P. A. Crossey, and M. T. Kearney Preserved Glucoregulation but Attenuation of the Vascular Actions of Insulin in Mice Heterozygous for Knockout of the Insulin Receptor Diabetes, October 1, 2004; 53(10): 2645 - 2652. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Natali, S. Baldeweg, E. Toschi, B. Capaldo, D. Barbaro, A. Gastaldelli, J. S. Yudkin, and E. Ferrannini Vascular Effects of Improving Metabolic Control With Metformin or Rosiglitazone in Type 2 Diabetes Diabetes Care, June 1, 2004; 27(6): 1349 - 1357. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Clement, S. S. Braithwaite, M. F. Magee, A. Ahmann, E. P. Smith, R. G. Schafer, and I. B. Hirsch Management of Diabetes and Hyperglycemia in Hospitals Diabetes Care, February 1, 2004; 27(2): 553 - 591. [Full Text] [PDF]
|
|
|
|
 |
|
 J. Westerbacka, R. Bergholm, M. Tiikkainen, and H. Yki-Jarvinen Glargine and Regular Human Insulin Similarly Acutely Enhance Endothelium-Dependent Vasodilatation in Normal Subjects Arterioscler. Thromb. Vasc. Biol., February 1, 2004; 24(2): 320 - 324. [Abstract] [Full Text]
|
|
|
|
|
|
S. Vehkavaara and H. Yki-Jarvinen 3.5 Years of Insulin Therapy With Insulin Glargine Improves In Vivo Endothelial Function in Type 2 Diabetes Arterioscler. Thromb. Vasc. Biol., February 1, 2004; 24(2): 325 - 330. [Abstract] [Full Text]
|
|
|
|
|
|
L. Li, T. Sawamura, and G. Renier Glucose Enhances Endothelial LOX-1 Expression: Role for LOX-1 in Glucose-Induced Human Monocyte Adhesion to Endothelium Diabetes, July 1, 2003; 52(7): 1843 - 1850. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. M. Fernandez-Real, G. Penarroja, A. Castro, F. Garcia-Bragado, A. Lopez-Bermejo, and W. Ricart Blood Letting in High-Ferritin Type 2 Diabetes: Effects on vascular reactivity Diabetes Care, December 1, 2002; 25(12): 2249 - 2255. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. Hallsten, K. A. Virtanen, F. Lonnqvist, H. Sipila, A. Oksanen, T. Viljanen, T. Ronnemaa, J. Viikari, J. Knuuti, and P. Nuutila Rosiglitazone but Not Metformin Enhances Insulin- and Exercise-Stimulated Skeletal Muscle Glucose Uptake in Patients With Newly Diagnosed Type 2 Diabetes Diabetes, December 1, 2002; 51(12): 3479 - 3485. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 L. Ryden and K. Malmberg Who are the enemies? Diabetes mellitus -- a major risk factor for ischaemic myocardial injury: new directions in the management of acute coronary syndromes in the diabetic patient Eur. Heart J. Suppl., November 1, 2002; 4(suppl_G): G21 - G25. [Abstract] [PDF]
|
|
|
|
|
|
F. V. van Venrooij, M. A. van de Ree, M. L. Bots, R. P. Stolk, M. V. Huisman, and J. D. Banga Aggressive Lipid Lowering Does Not Improve Endothelial Function in Type 2 Diabetes: The Diabetes Atorvastatin Lipid Intervention (DALI) Study: a randomized, double-blind, placebo-controlled trial Diabetes Care, July 1, 2002; 25(7): 1211 - 1216. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. W. van Etten, E. J.P. de Koning, M. L. Honing, E. S. Stroes, C. A. Gaillard, and T. J. Rabelink Intensive Lipid Lowering by Statin Therapy Does Not Improve Vasoreactivity in Patients With Type 2 Diabetes Arterioscler. Thromb. Vasc. Biol., May 1, 2002; 22(5): 799 - 804. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. Rask-Madsen, N. Ihlemann, T. Krarup, E. Christiansen, L. Kober, C. Nervil Kistorp, and C. Torp-Pedersen Insulin Therapy Improves Insulin-Stimulated Endothelial Function in Patients With Type 2 Diabetes and Ischemic Heart Disease Diabetes, November 1, 2001; 50(11): 2611 - 2618. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. M Storey, C. J Perry, and J. R Petrie Review: Endothelial dysfunction in type 2 diabetes The British Journal of Diabetes & Vascular Disease, August 1, 2001; 1(1): 22 - 27. [Abstract] [PDF]
|
|
|
|
|
|
P. Dandona, A. Aljada, P. Mohanty, H. Ghanim, W. Hamouda, E. Assian, and S. Ahmad Insulin Inhibits Intranuclear Nuclear Factor {{kappa}}B and Stimulates I{{kappa}}B in Mononuclear Cells in Obese Subjects: Evidence for an Anti-inflammatory Effect? J. Clin. Endocrinol. Metab., July 1, 2001; 86(7): 3257 - 3265. [Abstract] [Full Text] [PDF]
|
|