Improvement of cardiovascular risk factors in patients with type 2 diabetes after long-term continuous subcutaneous insulin infusion.

Abstract

BACKGROUND:

The effects of long-term continuous subcutaneous insulin infusion (CSII) on cardiovascular risk factors such as hyperglycaemia, dyslipidaemia, and proinflammatory cytokine levels have not been assessed so far in type 2 diabetes.

METHODS:

We analysed the levels of HbA(1c), serum lipids, tumor necrosis factor alpha (TNF-alpha), and interleukin 6 (IL-6) at 0, 2, and 30 weeks after CSII in 15 patients with type 2 diabetes (mean age, 53.3+/-10.1 years; disease duration, 9.4+/-5.3 years) without previous history of major cardiovascular events.

RESULTS:

At week 30, CSII significantly lowered HbA(1c) by 5.0+/-0.9% compared to baseline (7.9+/-1.9%, p<0.001) and improved high-density lipoprotein cholesterol (HDLc; 1.09+/-0.16 at baseline vs 1.25+/-0.15 mmol/L at week 30; p<0.05) and low-density lipoprotein cholesterol (LDLc)/HDLc ratios (2.8+/-1.4 at baseline vs 2.2+/-0.9 at week 30; p<0.05). CSII also decreased the proportion of patients with dyslipidaemia at week 30. At baseline, TNF-alpha and IL-6 levels were up-regulated (2.65+/-4.04 and 2.82+/-1.81 pg/mL, respectively) compared to the normal control (p<0.01 and p<0.05, respectively); however, cytokine levels decreased significantly at week 30 (1.44+/-2.25 and 1.99+/-1.05 pg/mL, respectively; p=NS vs control).

CONCLUSIONS:

Long-term CSII alone decreased cardiovascular risk factors in poorly controlled type 2 diabetes, suggesting that the synchronization of sufficient insulin peaks with meal ingestion and continuous pulsatile infusion of basal insulin corrects metabolic derangements.

• Authors: Yun-Hee Noh, Se-Myung Lee, Eun-Ju Kim, Do-Young Kim, Hyunil Lee, Jun-Ho Lee, Ju-Han Lee, So-Young Park, Ja-Hyun Koo, Jun-Ho Wang, In-Ja Lim, Soo-Bong Choi
• Journal: Diabetes/metabolism research and reviews (Diabetes Metab Res Rev) 2008 Jul-Aug Vol. 24 Issue 5 Pg. 384-91 ISSN: 1520-7552 [Print] England
• PMID: 18461633 (Publication Type: Clinical Trial, Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Blood Glucose
• Insulin
• Interleukin-6
• Lipids
• Tumor Necrosis Factor-alpha

Topics

• Abdomen (anatomy & histology)
• Adult
• Aged
• Blood Glucose (metabolism)
• Body Mass Index
• Cardiovascular Diseases (etiology)
• Diabetes Mellitus, Type 2 (complications, drug therapy)
• Drug Administration Schedule
• Female
• Humans
• Injections, Subcutaneous
• Insulin (administration & dosage)
• Insulin Infusion Systems
• Interleukin-6 (blood)
• Lipids (blood)
• Male
• Middle Aged
• Risk Factors
• Tumor Necrosis Factor-alpha (blood)