Aim To evaluate effects of intensive insulin treatment modalities on cardiovascular biomarkers in patients with type 1 diabetes mellitus (T1DM). Materials and methods A total of 25 patients with T1DM receiving intensive insulin therapy either in the form of continuous insulin pump (IP group; n = 13) or as multiple daily injections (MDI group; n = 12) and 13 controls (control group, n = 13) were included. Data on demographics, anthropometrics, diabetes history, and laboratory findings including glycemic and lipid parameters, and cardiovascular biomarkers [C-reactive protein (mg/dL), homocysteine (μmol/L), fibrinogen (mg/dL), oxidized LDL (ng/dL), PAI-1 (ng/mL), MCP-1 (pg/mL) and VEGF (pg/mL)] were recorded in each group. Correlation of cardiovascular biomarkers to other parameters was also evaluated in T1DM patients. Results Apart from significantly higher mean (SD) values for HbA1c [6.1 (0.3) vs. 5.6 (0.5)% (43 (3) vs. 38 (5) mmol/mol), p < 0.05)] and HDL-cholesterol [71.5 (13.6) vs. 58.2 (10.8), p < 0.01) in the IP than in the MDI group, no significance difference was noted between insulin treatment modalities as well as between patient and control groups in terms of demographic, anthropometric and laboratory parameters. Negative correlation of MCP-1 to treatment duration (r = -0.615, p = 0.025), and HDL-c to CRP (r = -0.685, p = 0.010) and VEGF (r = -0.678, p = 0.011) was noted in IP group, whereas positive correlation of PAI-1 to diabetes age (r = 0.805, p = 0.002) and treatment duration was noted in MDI group. Conclusion Our findings in a cohort of T1DM patients with optimal glycemic control revealed that intensive insulin therapy was not associated with an increase in atherosclerotic markers in T1DM, regardless of whether continuous IP infusion or MDIs was administered. © 2015 Diabetes India.

MeSH

Adult; Biomarkers; C-Reactive Protein; Cardiovascular Diseases; Chemokine CCL2; Cohort Studies; Diabetes Mellitus, Type 1; Female; Fibrinogen; Homocysteine; Humans; Injections; Insulin; Insulin Infusion Systems; Lipoproteins, LDL; Male; Plasminogen Activator Inhibitor 1; Vascular Endothelial Growth Factor A

EMTREE drug terms

biological marker; C reactive protein; fibrinogen; high density lipoprotein; high density lipoprotein cholesterol; homocysteine; insulin; lipid; monocyte chemotactic protein 1; oxidized low density lipoprotein; vasculotropin; biological marker; C reactive protein; CCL2 protein, human; fibrinogen; homocysteine; insulin; low density lipoprotein; monocyte chemotactic protein 1; oxidized low density lipoprotein; plasminogen activator inhibitor 1; vasculotropin A; VEGFA protein, human

EMTREE medical terms

adult; anthropometry; Article; clinical article; controlled study; diabetes mellitus; female; glycemic control; human; insulin dependent diabetes mellitus; insulin pump; insulin resistance; insulin treatment; male; priority journal; treatment duration; adverse effects; blood; Cardiovascular Diseases; cohort analysis; comparative study; Diabetes Mellitus, Type 1; injection; insulin infusion; metabolism