Key result
Insulin resistance and compensatory hyperinsulinaemia play a central role in the pathogenesis of the severe vascular disease characteristic of diabetes.
Highlights the central role of insulin resistance in the development of severe vascular disease in patients with diabetes.
Emphasizes insulin resistance as therapeutic target in diabetic vasculopathy; leaves open need for interventional trials to confirm benefit.
Only recently are we beginning to understand the complex interplay of factors involved in vascular disease and diabetes. Insulin resistance provides a starting point to explain the many factors that lead to the more severe vascular disease characteristic of diabetes. Insulin resistance syndrome comprises insulin resistance and compensatory hyperinsulinaemia as well as hypertension, dyslipidaemia, macrovascular disease, and increased plasminogen activator inhibitor-1 activity. The development of type 2 diabetes may be viewed as the inability of the pancreas to continue to overcome insulin resistance, even with excessive insulin production.
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John A. Colwell (2000) conducted a review in Vascular disease and diabetes. Insulin resistance and compensatory hyperinsulinaemia play a central role in the pathogenesis of the severe vascular disease characteristic of diabetes.
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