PMID- 11852379
OWN - NLM
STAT- MEDLINE
DCOM- 20020329
LR  - 20111117
IS  - 1262-3636 (Print)
IS  - 1262-3636 (Linking)
VI  - 27
IP  - 6
DP  - 2001 Dec
TI  - Insulin therapy may increase blood pressure levels in type 2 diabetes mellitus.
PG  - 695-700
AB  - OBJECTIVE: To assess the effects of insulin therapy on blood pressure levels in 
      type 2 diabetes mellitus (T2 DM). MATERIAL AND METHODS: This is a retrospective 
      analysis of clinical records of 313 T2DM patients (125 men and 188 women), 
      excluding those with proteinuria or hypertensive diseases and those taking drugs 
      that may influence blood pressure levels except antihypertensive therapy. Mean 
      age was 56.3 +/- 11.7 years and mean duration of diabetes was 7.1 +/- 5.5 years. 
      After one week of observation under diet and maximal doses of oral antidiabetic 
      drugs, patients who did not improve their glucose control were changed towards 
      insulin therapy (n=129) and formed the insulin treated group (ITG), those who 
      improved their glucose levels were maintained under oral therapy (n=184) and 
      formed the orally treated group (OTG). Blood pressure levels were compared 
      between the two groups at baseline and after a mean follow-up period of 12.1 +/- 
      6.1 months. Hypertension was considered if patients were known and treated or if 
      SBP >=140 mmHg and/or DBP >=90 mmHg. RESULTS: At baseline, patients in ITG were 
      moderately older (58.4 +/- 11 vs 54.9 +/- 12.1 years, p<0.05), had a longer 
      duration of diabetes (9.2 +/- 6.2 vs 5.7 +/- 5 years, p<0.01), a lower BMI (24.6 
      +/- 4.6 vs 28.8 +/- 6.6 kg/m(2), p<0.01) and a higher frequency of retinopathy 
      (44% vs 31.1%, p<0.05). There was no significant difference regarding sex ratio, 
      WHR, family history of hypertension, plasma levels of creatinine and lipid 
      parameters. SBP, DBP and frequency of hypertension were similar in both groups at 
      baseline. After follow up, insulin treated group exhibited higher levels of SBP 
      (150 +/- 25.7 vs 138.6 +/- 27.1 mmHg, p<0.001) and DBP (84.1 +/- 13 vs 75.8 +/- 
      14.9 mmHg, p<0.001) than orally treated group. Progression rate of hypertension 
      frequency was mildly but not significantly higher in ITG than in OTG (+21% vs 
      +12%, p=0.08) and was associated with weight gain in ITG only. SBP increase was 
      mildly correlated with weight gain (p=0.06). In ITG, higher values of BMI (> 27 
      kg/m(2)) at baseline were associated with the highest increases of blood pressure 
      levels under insulin therapy. No significant relationship was found with insulin 
      doses. CONCLUSION: Insulin therapy may contribute to the development of 
      hypertension in T2DM obese patients. Additional prospective randomised studies 
      are required for a better appreciation of such influence.
FAU - Kanoun, F
AU  - Kanoun F
AD  - Department of Endocrinology/Diabetology, Hopital La Rabta, 1007 BS Tunis, 
      Tunisia.
FAU - Ben Amor, Z
AU  - Ben Amor Z
FAU - Zouari, B
AU  - Zouari B
FAU - Ben Khalifa, F
AU  - Ben Khalifa F
LA  - eng
PT  - Journal Article
PL  - France
TA  - Diabetes Metab
JT  - Diabetes & metabolism
JID - 9607599
RN  - 0 (Hypoglycemic Agents)
RN  - 0 (Insulin)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Body Constitution
MH  - Body Mass Index
MH  - Diabetes Mellitus, Type 2/complications/*drug therapy
MH  - Diabetic Angiopathies/complications
MH  - Diabetic Retinopathy/complications
MH  - Female
MH  - Humans
MH  - Hypertension/*chemically induced
MH  - Hypoglycemic Agents/therapeutic use
MH  - Insulin/administration & dosage/*adverse effects
MH  - Male
MH  - Middle Aged
MH  - Retrospective Studies
EDAT- 2002/02/20 10:00
MHDA- 2002/03/30 10:01
CRDT- 2002/02/20 10:00
PHST- 2002/02/20 10:00 [pubmed]
PHST- 2002/03/30 10:01 [medline]
PHST- 2002/02/20 10:00 [entrez]
AID - MDOI-DM-12-2001-27-6-1262-3636-101019-ART10 [pii]
PST - ppublish
SO  - Diabetes Metab. 2001 Dec;27(6):695-700.