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Shirwan A. Mirza, MD

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Hyperinsulinemia of insulin resistance occurs because of a lack of vasodilatory and anti-inflammatory effects of insulin. It is not the insulin itself, but the loss of its anti-inflammatory effects due to insulin resistance that is the culprit in atherosclerosis of diabetes.¹

Tseng² states that the benefit of lowering blood glucose levels with exogenous insulin may be counteracted by the potential risk for insulin-induced atherosclerosis. Tseng² frequently reiterates the atherogenic effects of insulin as if it were a proven fact. I find that the conclusion of this study, that insulin users are at higher risk for development of hypertension, is a speculation based on a flawed premise.

When comparing the users and nonusers of insulin, lipid profile was not measured in either group. Lipid status in people with type 2 diabetes mellitus is very relevant in assessing atherogenesis as an underlying cause for hypertension, whether insulin is . . . [Full Text of this Article]

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RELATED LETTER

It Is Time We Ended the Myth of Insulin as an Atherogenic Hormone—Reply
Chin-Hsiao Tseng
Arch Intern Med. 2007;167(8):859.
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