Insulin exposure mitigates the increase of arterial stiffness in patients with type 2 diabetes and albuminuria: an exploratory analysis.

ABSTRACT: AIMS:Insulin possesses both vasodilatory and sympathomimetic activities. The aim was to examine the relationship between changes in insulin exposure and arterial stiffness in type 2 diabetes (T2D). METHODS:Patients with T2D with (n?=?22) or without (n?=?24) albuminuria, and non-diabetic controls (n?=?25) were randomized to a crossover study having a breakfast with or without pre-meal rapid-acting insulin. Pulse wave velocity (PWV) was measured at 30 min before and at 60-min intervals up to 240 min after the breakfast. RESULTS:At baseline, both postprandial aortic (p?=?0.022) and brachial (p?=?0.011) PWV were higher in individuals with T2D than in healthy controls irrespective of the presence of albuminuria. In patients with albuminuria, weight-adjusted insulin dose correlated inversely with the excursion of the aortic (r?=?-?0.412, p?=?0.006) and brachial (r?=?-?0.372; p?=?0.014) PWV. Similarly, circulating endogenous insulin concentrations correlated inversely with the aortic (r?=?-?0.347, p?=?0.026) and brachial (r?=?-?0.622, p?=?<0.001) PWV. No correlations between insulin and PWV were observed in patients without albuminuria or in healthy controls. CONCLUSIONS:The inverse correlation between insulin and PWV in T2D with albuminuria may reflect a vasorelaxing effect of insulin. CLINICAL TRIAL REGISTRATION NUMBER:The study was registered (clinicaltrials.gov) with the identifier of NCT01159938.

SUBMITTER: Gordin D 

PROVIDER: S-EPMC6768891 | biostudies-literature | 2019 Nov

REPOSITORIES: biostudies-literature