Vascular Disease in Juvenile Diabetic Patients of Long Duration: A Preliminary Report

Diabetes and atherosclerosis ? The role of insulin

“…Atherosclerosis is a slowly progressive disorder, becoming clinically manifest with advancing years, and it would be expected that there would be a relation between the duration of diabetes and the incidence of atherosclerosis. Such a relationship has been described by some [18][19][20][21], but not all authors [22][23][24][25][26]. As the incidence of both glucose intolerance and arterial disease increases with advancing years, it may be age rather than duration of diabetes that is important [22].…”

“…There appears to be little [21] or no [18,22,23] relationship between the frequency of the large vessel complications and the severity of diabetes, as measured by the degree of hyperglycaemia or the treatment required. Nor is the degree of 'control' of diabetes by treatment related to the occurrence of atherosclerotic heart disease [22].…”

Insulin sensitivity and vascular disease in insulin-dependent diabetics.

“…An increased incidence of insulin antagonists as measured by the in vitro rat diaphragm technique has been described in juvenile-onset diabetics of long duration with angiopathic vascular disease (Bornstein and Hyde, 1959;Downie and Martin, 1959), and Alivisatos and McCullagh (1956) reported that vascular disease was much more common in stable than in brittle diabetics on insulin. The present results show that in insulin-dependent diabetics the presence of both clinical diabetic angiopathy and atherosclerosis is associated with a reduction in the hy'poglycaemic effect of intravenous insulin.…”

Augmentation of synthesis of plasminogen activator inhibitor type 1 by insulin and insulin-like growth factor type I: implications for vascular disease in hyperinsulinemic states.

“…Growth factor-deficient dwarfs do not exhibit markedly accelerated atherosclerosis despite intense and sustained hyperglycemia (2). Furthermore, the severity of macrovascular complications in patients with diabetes mellitus does not correlate closely with the apparent severity of hyperglycemia (3) nor does stringent control of hyperglycemia translate into reduction of the incidence of fatal cardiovascular events (4).…”