M. Hanefeld et al., DETERMINANTS FOR CORONARY HEART-DISEASE IN NON-INSULIN-DEPENDENT DIABETES-MELLITUS - LESSONS FROM THE DIABETES INTERVENTION STUDY, Diabetes research and clinical practice, 30, 1996, pp. 67-70
In NIDDM a clustering of established coronary risk factors, e.g. the m
etabolic syndrome is responsible for excessive incidence of myocardial
infarction. The harmful effects of these risk factors are aggravated
by poor glucose control. Hyperinsulinaemia is associated with a higher
level of risk factors for coronary heart disease. Individuals with su
bsequent myocardial infarction exhibit higher levels of serum insulin
at entry. However, insulin in multivariate analysis was no independent
risk factor. Perfect control of blood glucose, triglycerides and bloo
d pressure was associated with a lower incidence of coronary heart dis
ease. By extrapolation an integrated approach to correct the anomalies
of the metabolic syndrome seems to be necessary to prevent macroangio
pathy and improve life expectancy.