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Type 2 Diabetics Who Use Insulin at Increased Risk for Hypertension

Posted: Friday, June 30, 2006

Patients with type 2 diabetes who use insulin are at heightened risk for developing hypertension.

Using national health insurance records, Dr. Chin-Hsiao Tseng from the National Taiwan University Hospital in Taipei identified 87,850 adults with type 2 diabetes from national health insurance records that included 5,927 insulin users.

After adjusting for age, sex, body mass index, duration of diabetes, smoking and parental history of hypertensive, the odds ratio for hypertension was 1.14 in those who used insulin for less than 5 years compared with those you didn't use insulin.

The hypertension risk increased with the duration of insulin use; the odds ratio was 1.35 in diabetics who used insulin for 5 to 9 years and 1.46 in those who used insulin for 10 years or more.

Among insulin users who were normotensive when they started using insulin, the respective adjusted odds ratios for hypertension in those using insulin for 5 to 9 years and 10 years or longer were 1.5 and 2.15, compared with those using insulin for less than 5 years.

"The findings consistently favored the hypothesis that use of exogenous insulin might induce hypertension, independent of the effect of potential confounders, based on the strength of the association, dose-response relationship, consistency in different analyses, correctness for temporality, and biological plausibility," Dr. Tseng writes.

Patients taking pharmacologic dosages of insulin "may be repetitively exposed to high concentrations of insulin," Dr. Tseng explains. "This excess of insulin may exert detrimental effects on the vascular system, leading to elevated blood pressure."



Source: Diabetes In Control: Arch Intern Med 2006;166:1184-1189

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