Hormonal
Insulin resistance (IR) and hyperinsulinemia are independent, nontraditional risk factors for cardiovascular disease (CVD) in type 2 diabetes, contributing to excess morbidity and mortality beyond traditional risk factors like hypertension and dyslipidemia.
If you have type 2 diabetes or insulin resistance, your risk of heart disease is higher than what standard blood pressure and cholesterol tests show. This is largely driven by how your body handles insulin. Focus on improving insulin sensitivity through lifestyle changes (like weight management and exercise) and medications that address insulin resistance, not just traditional risk factor management.
Traditional risk factors do not fully explain this excess risk, and other 'nontraditional' risk factors may be important... hyperinsulinemia may be an important risk factor for ischemic heart disease... High fasting insulin concentrations were an independent predictor of ischemic heart disease... after adjustment for systolic blood pressure, family history... plasma triglyceride... LDL cholesterol, and HDL cholesterol concentrations.
Why this rating
The paper cites multiple prospective epidemiological studies (Quebec Heart Study, Helsinki Policemen Study) and meta-analyses supporting the association.
Source
Nontraditional Risk Factors for Cardiovascular Disease in Diabetes
Vivian Fonseca et al. · Endocrine Reviews · 2004
DOI 10.1210/er.2002-0034
More from this paper
- Endothelial dysfunction, characterized by impaired nitric oxide (NO) production and increased asymmetric dimethylarginine (ADMA), is an early and independent predictor of cardiovascular events in diabetes, often preceding clinical symptoms.Good
- Inflammation, marked by elevated C-reactive protein (CRP), white blood cells, and adhesion molecules, is a key nontraditional risk factor for CVD in diabetes, linked to insulin resistance and obesity.Good
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