Don't Blame Insulin for Poor Cardiovascular Outcomes
The main thing to remember with a registry study such as this is that people with diabetes are switched to insulin for a reason. They get started on diet and progress in therapy. If each stage fails, we proceed toward insulin. And the reasons for switching are bad response to a first-line medication. And that is reflected in these results.
Even within this group with diabetes there are different levels of insulin sensitivity and those who are most insulin resistant require more insulin at an earlier stage. This might explain some of these findings. The other issue is duration of treatment, and registry studies can’t take that into account. I would be very hesitant to say that insulin is a causal factor in any of these complications.
Dr. Daniel Witte is a research manager at the Steno Diabetes Center in Gentofte, Denmark.
FROM THE ANNUAL MEETING OF THE EUROPEAN ASSOCIATION FOR THE STUDY OF DIABETES
Dr. Norhammar reported having no financial conflicts of interest.
