• Online Features  This Article  • Full text  • PDF  • Reply to article  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on Web of Science (15)  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Topic Collections  • Neurology  • Endocrine Diseases  • Diabetes Mellitus  • Hypertension  • Alert me on articles by topic  Social Bookmarking   What's this?

Chin-Hsiao Tseng, MD, PhD

Arch Intern Med. 2006;166:1184-1189.

Background  Endogenous hyperinsulinemia, along with insulin resistance, is associated with hypertension. This study investigated the link between exogenous insulin use and hypertension in patients with type 2 diabetes mellitus.

Methods  Using national health insurance records in Taiwan, data from 87 850 adult patients with type 2 diabetes mellitus were collected cross-sectionally with retrospective recall for onset of events. Data were analyzed to evaluate the strength of association, consistency, dose-response relationship, and temporality between exogenous insulin use and hypertension.

Results  There were 5927 insulin users, who were characterized by being 1 year older in age, female preponderance, longer duration of diabetes, slightly lower body mass index, and less smoking but higher prevalence of hypertension with higher blood pressure. After adjustment for age, sex, body mass index, duration of diabetes, smoking, and parental hypertension, the odds ratios (95% confidence interval [CI]) for hypertension for patients using insulin for less than 5 years, 5 to 9 years, and 10 years or more were 1.14 (95% CI, 1.06-1.23), 1.35 (95% CI, 1.18-1.54), and 1.46 (95% CI, 1.24-1.74), respectively, compared with nonusers. In insulin users who did not have hypertension at the start of insulin use, the respective odds ratios for those using insulin for 5 to 9 years and 10 years or more were 1.5 (95% CI, 1.25-1.80) and 2.15 (95% CI, 1.72-2.70), respectively, compared with those using insulin for less than 5 years.

Conclusions  In patients with type 2 diabetes mellitus, insulin users are at higher risk for development of hypertension. These observational data suggest the need for further study of the relationship between exogenous insulin use and hypertension.

Author Affiliations: Division of Endocrinology and Metabolism, Department of Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, School of Public Health, Taipei Medical University, and Division of Environmental Health and Occupational Medicine of the National Health Research Institutes, Taipei.

CiteULike    Connotea    Delicious    Digg    Facebook    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Diabetes and non-Hodgkin's lymphoma: analyses of prevalence and annual incidence in 2005 using the National Health Insurance database in Taiwan
Tseng
Ann Oncol 2012;23:153-158.
ABSTRACT | FULL TEXT  

Relationship of Glycemic Control, Exogenous Insulin, and C-Peptide Levels to Ischemic Heart Disease Mortality Over a 16-Year Period in People With Older-Onset Diabetes: The Wisconsin Epidemiologic Study of Diabetic Retinopathy (WESDR)
Hirai et al.
Diabetes Care 2008;31:493-497.
ABSTRACT | FULL TEXT  

Exogenous Insulin Use and Hypertension
Oh et al.
Arch Intern Med 2007;167:857-858.
FULL TEXT  

It Is Time We Ended the Myth of Insulin as an Atherogenic Hormone
Mirza
Arch Intern Med 2007;167:858-859.
FULL TEXT  

It Is Time We Ended the Myth of Insulin as an Atherogenic Hormone--Reply
Tseng
Arch Intern Med 2007;167:859-859.
FULL TEXT