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A Randomized Cross‐over Study of the Effects of Proinsulin on Lipid Metabolism in Type 2 Diabetes
Author(s) -
Winocour P.H.,
Mallik T.H.,
Ishola M.,
Baker R.D.,
Bhatnagar D.,
Durrington P.N.,
Anderson D.C.
Publication year - 1991
Publication title -
diabetic medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.474
H-Index - 145
eISSN - 1464-5491
pISSN - 0742-3071
DOI - 10.1111/j.1464-5491.1991.tb01511.x
Subject(s) - medicine , proinsulin , type 2 diabetes , diabetes mellitus , lipid metabolism , endocrinology , randomized controlled trial
The effects of human proinsulin and insulin on lipid metabolism in Type 2 diabetes were examined in a randomized cross‐over study in 15 patients. Blood glucose control was indistinguishable at the end of the two treatment periods, but fasting levels of triglycerides appeared somewhat lower after proinsulin (1.17(SE 0.16) vs 1.39(0.21) mmol I −1 ; p<0.07), and the maximal postprandial triglyceride response (2.19(0.25) vs 2.87(0.28) mmol I −1 , p < 0.001) and triglyceride area under the curve ( p < 0.01) were significantly reduced. In five hyperlipidaemic patients postprandial triglyceridaemia was reduced with proinsulin (2.89(0.60) vs 3.68(0.56); p < 0.001), but in addition fasting serum triglycerides (1.20(0.30) vs 1.96(0.30) mmol I −1 , p < 0.04) and possibly VLDL‐cholesterol (0.49(0.15) vs 0.60(0.20) mmol I −1 ; p < 0.10) were lower and fasting LDL‐cholesterol levels higher (4.82(0.42) vs 3.92(0.57) mmol I −1 , p < 0.03) after proinsulin therapy. Proinsulin appears to preferentially suppress the production of triglyceride‐rich lipoproteins in Type 2 diabetes, particularly postprandially, and may enhance their clearance and conversion to LDL, especially in hyperlipidaemic Type 2 diabetes