Question:
From Metairie, Louisiana, USA:
Do type 1s on high levels of insulin (more than 1 unit per kg of body weight) have the same risk of developing cardiovascular complications as type 2s who are insulin resistant? Are there any studies that I can be referred to for information?
Answer:
Current dogma is that the long term complications of diabetes are primarily due to the glycosylation (bonding to glucose) of a number of
proteins particularly in the walls of blood vessels and in nerves. This in turn is a function of abnormally elevated blood glucose levels and the length of time that this elevation has existed. The changes due to diabetes are likely to have a greater effect in the blood vessels of older people in whom similar; but differently caused changes may already exist.
What has not been explored to any great degree is the extent to which the relationship may depend on the precise diagnosis of the cause of the insulin resistance. For example, the relative risk in the above terms between say Insulin Resistance Type A, lipodystrophic diabetes and high insulin dose situations due to management or psychosocial problems is not known. But again, what is important is meticulous blood sugar control.
DO'B
Original posting 2 Oct 1998
Posted to Complications
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