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Association of hyperglycemia and insulin with diabetic cardiovascular complications
Mogher Khamaisi1, Julio Wainstein, Nicolae Hancu
1Diabetes Center, Department of Internal Medicine, Hadassah University Hospital, Jerusalem, Israel.
Insights
High blood glucose levels, particularly after meals, significantly increase cardiovascular disease risk and mortality in diabetic patients. This review examines glucose metabolism, insulin, and cardiovascular outcomes.
Area of Science:
- Endocrinology
- Cardiology
- Metabolic Syndrome
Background:
- Patients with diabetes and/or insulin resistance syndrome face elevated cardiovascular disease (CVD) risks.
- The UK Prospective Diabetes Study (UKPDS) initiated discussions on hyperglycemia's role in CVD development.
- Emerging evidence links high postprandial blood glucose to increased CVD risk and poorer outcomes during acute coronary events.
Purpose of the Study:
- To review current knowledge on the relationship between blood glucose, insulin levels, and cardiovascular morbidity and mortality.
- To contextualize these findings within the latest World Health Organization (WHO) and American Diabetes Association (ADA) classifications of disturbed glucose metabolism.
Main Methods:
- Literature review of epidemiologic studies and reports.
- Synthesis of data on postprandial hyperglycemia, insulin, and cardiovascular events.
- Analysis of findings in relation to current diabetes classifications.
Main Results:
- Postprandial hyperglycemia is increasingly recognized as a significant risk factor for cardiovascular events.
- Elevated postprandial glucose levels are associated with a grave prognosis in patients experiencing acute coronary events.
- Research suggests postprandial hyperglycemia contributes to overall mortality.
Conclusions:
- Postprandial hyperglycemia is a critical modifiable risk factor for cardiovascular disease in diabetic and insulin-resistant populations.
- Understanding the interplay between glucose metabolism and cardiovascular health is crucial for patient management.
- Current classifications of disturbed glucose metabolism provide a framework for assessing cardiovascular risk.
Abstract:
Patients with diabetes and/or insulin resistance syndrome are at increased risk for developing cardiovascular disease. The UKPDS raised a great debate about the relative importance of hyperglycemia in the development of cardiovascular disease. Recently, several epidemiologic studies have suggested that high postprandial blood glucose levels are associated with a significant risk for the development of cardiovascular disease well as a grave prognosis for these patients during acute coronary events. In addition, a number of reports reinforce the thesis that postprandial hyperglycemia is a risk factor for mortality. Our review summarizes the current knowledge on the relation between blood glucose, insulin levels, and cardiovascular morbidity and mortality, relating these data to the new World Health Organization and American Diabetes Association classification of disturbed glucose metabolism.