[Insulin therapy in diabetic patient with hypertension]

The advantage of insulin therapy for diabetic patient with hypertension is still controversial. Hyperinsulinemia, as well as insulin resistance have been known to be associated with hypertension and cardiovascular disease. Some mechanisms are reported in the conditions of hyperinsulinemia to induce hypertension and atherosclerosis. However, in many intervention studies, the intensive insulin therapy provided promising effects on preventing cardiovascular disease. Moreover, insulin have been shown to stimulate nitric oxide production by cultured endothelial cells, and to suppress the expression of intercellular adhesion molecule-1(ICAM-1), at least in vitro. In view of this anti-inflammatory effect, long-term insulin therapy may potentially have an anti-atherogenic effect.