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Insulin Therapy Increases Cardiovascular Risk in Type 2 Diabetes
Mary E Herman1, James H O'Keefe2, David S H Bell3
1Montclair State University, New Jersey, United States; Social Alchemy Ltd. Building Global Research Competency, United States.
Progress in Cardiovascular Diseases
|September 30, 2017
Summary
Insulin therapy for type 2 diabetes (T2D) is linked to increased cardiovascular risk and mortality. This review suggests potential adverse effects outweigh benefits compared to other T2D treatments.
Area of Science:
- Endocrinology
- Cardiology
- Pharmacology
Background:
- Recent trials indicate insulin therapy may increase cardiovascular (CV) risk and mortality in type 2 diabetes (T2D) patients.
- Conflicting results exist, necessitating a comprehensive assessment of insulin's CV effects in T2D.
Purpose of the Study:
- To evaluate the association between insulin therapy and CV health/longevity in T2D.
- To determine if the observed CV risks are causative or coincidental.
Main Methods:
- Systematic review of PubMed literature, including large-scale outcomes trials, meta-analyses, patient registry studies, and basic research.
- Analysis of direct and pleiotropic actions of insulin.
Main Results:
- The majority of large observational studies show a dose-dependent association between injected insulin and increased CV risk and mortality.
- Insulin therapy is linked to weight gain, hypoglycemia, iatrogenic hyperinsulinemia, inflammation, atherosclerosis, hypertension, dyslipidemia, heart failure, and arrhythmias.
- Insulin therapy appears to have a poorer safety profile than many other anti-T2D therapies.
Conclusions:
- Insulin therapy for T2D may pose significant CV risks and worsen mortality.
- Potential adverse effects of insulin should be carefully weighed against the benefits of alternative T2D therapies with proven CV benefits.
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