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  • 1.
    Persson, Sylvi Ulrika
    Department of Health Sciences and Social Work, University of Växjö, Sweden.
    Blood pressure reactions to insulin treatment in patients with type 2 diabetes2007In: International Journal of Angiology, ISSN 0392-9590, E-ISSN 1827-1839, Vol. 16, no 4, p. 135-138Article in journal (Refereed)
    Abstract [en]

    Abstract

    BACKGROUND: The institution of insulin therapy may be easy and uncomplicated in some Type 2 diabetics, but in others, mainly the obese patients, problems often arise (e.g. poor compliance, worsening B-cell function and/or insulin resistance).  

    METHODS: As a substudy of a broader investigation, concerning hemorheological effects of insulin treatment in insufficiently controlled type 2 diabetics, blood pressure was recorded in 12 patients at baseline, after two months and after four months on insulin.

    RESULTS: After two months on insulin analyses of triglycerides, high density lipoprotein cholesterol and total cholesterol indicated metabolic improvement (p<0.05 to 0.001) and a surprisingly uniform increase of blood pressure values (p<0.05 to 0.01) was found. At the same time, the serum sodium concentration increased (p<0.01) and was positively correlated to both systolic and diastolic blood pressure (p<0.01).

    After four months on insulin, blood pressure returned to pre-treatment values or even lower (p<0.05 to 0.01). Serum sodium also decreased to pretreatment values. No significant changes of the flow behaviour of blood were seen after institution of insulin.

    CONCLUSIONS: The number of patients was small and the study was not primarily designed to examine blood pressure. The preliminary conclusion from this study, however, is that the initiation of insulin treatment in poorly controlled type 2 diabetics causes a temporary and possibly clinically significant elevation of blood pressure. A changed renal handling of sodium caused by insulin, may be one of several possible explanations to the results, but further studies are warranted to confirm the findings.

    Key words: Blood pressure; Insulin therapy; NIDDM; Sodium excretion.

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