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Use of insulin to improve glycemic control in diabetes mellitus

Paresh Dandona1, Ajay Chaudhuri, Husam Ghanim

  • 1Division of Endocrinology, Diabetes and Metabolism, State University of New York at Buffalo, Buffalo, NY 14209, USA. pdandona@kaleidahealth.org

Cardiovascular Drugs and Therapy
|March 19, 2008
PubMed
Abstract

Insights

Intensive glycemic control alone may not prevent macrovascular disease in type 2 diabetes. Anti-inflammatory drugs may be crucial for preventing cardiovascular complications by targeting underlying inflammatory processes.

Area of Science:

  • Endocrinology
  • Cardiovascular Medicine
  • Metabolic Diseases

Background:

  • Normoglycemia controls diabetic symptoms but lacks conclusive evidence for preventing macrovascular disease in type 2 diabetes.
  • Atherosclerosis, a key driver of macrovascular complications, is linked to inflammatory processes in obesity and type 2 diabetes.
  • Glucose impacts endothelial cells, leukocytes, and platelets, inducing oxidative stress and a prothrombotic state.

Purpose of the Study:

  • To investigate the role of glucose and insulin in vascular complications.
  • To explore the potential of anti-inflammatory strategies in managing macrovascular disease in type 2 diabetes.

Main Methods:

  • Review of existing literature on glucose metabolism, inflammation, and atherosclerosis.
  • Analysis of the effects of glucose and insulin on cellular and vascular functions.

Main Results:

  • Glucose intake induces oxidative stress and prothrombotic effects on vascular cells.
  • Insulin exhibits cardioprotective and potentially anti-atherosclerotic effects at physiological concentrations.
  • Inflammatory processes in type 2 diabetes significantly promote atherosclerosis.

Conclusions:

  • Preventing macrovascular complications in type 2 diabetes may necessitate glucose-lowering drugs with anti-inflammatory properties.
  • Combined management of glycemic control, hypertension, and dyslipidemia is essential.
  • Further clinical trials are needed to confirm the benefits of this approach in macrovascular disease prevention.

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