Bohannon Nancy
Clin Cornerstone. 2003;Suppl 4:S21-7. doi: 10.1016/s1098-3597(03)90063-9.
Twenty-four percent of the adult American population have the metabolic syndrome. Although somewhat counterintuitive, carefully regulated treatment with insulin has been shown to reduce insulin resistance and may also retard the development of cardiovascular disease by preventing chronic hyperglycemia, a condition that synergistically contributes to many proatherogenic pathways, including glycoxidation, the polyol pathway, advanced glycation end products, interference with normal metabolic pathways, and stimulation of protein kinase C-beta and proinflammatory pathways. This article describes some of the physiologic changes that occur when hyperglycemia and insulin resistance develop in patients with type 2 diabetes and discusses therapies, including insulin, that normalize glucose and reduce insulin resistance, thereby potentially reducing cardiovascular risk.
24%的美国成年人口患有代谢综合征。尽管有些违反直觉，但已证明胰岛素的精心调控治疗可降低胰岛素抵抗，还可能通过预防慢性高血糖来延缓心血管疾病的发展，慢性高血糖会协同作用于许多促动脉粥样硬化途径，包括糖氧化、多元醇途径、晚期糖基化终产物、干扰正常代谢途径以及刺激蛋白激酶C-β和促炎途径。本文描述了2型糖尿病患者出现高血糖和胰岛素抵抗时发生的一些生理变化，并讨论了包括胰岛素在内的可使血糖正常化并降低胰岛素抵抗从而潜在降低心血管风险的治疗方法。
