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

✍ Scribed by 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

• Publisher: John Wiley and Sons
• Year: 2008
• Tongue: English
• Weight: 152 KB
• Volume: 24
• Category: Article
• ISSN: 1520-7552
• DOI: 10.1002/dmrr.849

✦ Synopsis

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 α (TNF‐α), 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‐α 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. Copyright © 2008 John Wiley & Sons, Ltd.