Why does quick‐release bromocriptine decrease cardiac events?

A placebo-controlled prospective safety study of quick-release bromocriptine in patients with type 2 diabetes has shown a 40% reduction in cardiovascular events. Possible explanations for this decrease are that through re-establishing diurnal variation a decrease in insulin resistance and its associated risk factors occurs. In addition, a decrease in the activity of the sympathetic nervous and renin-angiotensin systems and re-establishment of diurnal variations in the pituitary-adrenal axis may play a role. However, the most probable explanation is that because of the lowering of insulin resistance there are decreases in hepatic glucose production and an increased uptake of glucose leading to decreased levels of postprandial glucose, free fatty acids and triglycerides, which cause decreases in inflammation, oxidative stress and accumulation of atheroma.