Abstract

As a substudy of a broader investigation, concerning hemorheological effects of insulin treatment in insufficiently controlled type 2 diabetics, blood pressure was recorded in twelve patients before, after two months and after four months on insulin. After two months on insulin analyses of  MCV, S-Na, S-GT, total cholesterol, HDL-cholesterol and triglycerides indicated metabolic improvement (p<0.05-0.00 1). Besides a surprisingly uniform increase of both systolic and diastolic blood pressure (p<0.05) was found. No significant changes of the flow behaviour of blood were seen. After four months on insulin blood pressure had returned to pre-treatment values (p<0.05-0.01) or even lower. Further metabolic improvement (p<0.05-0.001) but no significant hemorheological improvement was now seen. Our number of patients was rather small and the study was not primarily designed for studies on blood pressure. Our preliminary conclusion from this study, however, has to be that institution of insulin treatment in poorly controlled type I1 diabetics causes a temporary and possibly clinically significant elevation of blood pressure. Further studies seem to be warranted to confirm our findings. Earlier studies have shown that insulin treatment may cause an increased albumin escape rate, increased plasma volume and systemic ("insulin-") oedema. A changed renal handling of sodium caused by insulin, might be one of several possible explanations to our results.