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Diabetologia

, Volume 36, Issue 7, pp 642–647 | Cite as

Insulin resistance, hypertension and microalbuminuria in patients with Type 2 (non-insulin-dependent) diabetes mellitus

  • L. Groop
  • A. Ekstrand
  • C. Forsblom
  • E. Widén
  • P. -H. Groop
  • A. -M. Teppo
  • J. Eriksson
Originals

Summary

We examined the impact of hypertension and microalbuminuria on insulin sensitivity in patients with Type 2 (non-insulin-dependent) diabetes mellitus using the euglycaemic insulin clamp technique in 52 Type 2 diabetic patients and in 19 healthy control subjects. Twenty-five diabetic patients had hypertension and 19 had microalbuminuria. Hypertension per se was associated with a 27% reduction in the rate of total glucose metabolism and a 40% reduction in the rate of non-oxidative glucose metabolism compared with normotensive Type 2 diabetic patients (both p<0.001). Glucose metabolism was also impaired in normotensive microalbuminuric patients compared with normotensive normoalbuminuric patients (29.4±2.2 vs 40.5±2.8 μmol · kg lean body mass−1 · min−1; p=0.012), primarily due to a reduction in non-oxidative glucose metabolism (12.7±2.9 vs 21.1±2.6 μmol · kg lean body mass−1 ·min−1; p=0.06). In a factorial ANOVA design, however, only hypertension (p=0.008) and the combination of hypertension and microalbuminuria (p=0.030) were significantly associated with the rate of glucose metabolism. The highest triglyceride and lowest HDL cholesterol concentrations were observed in Type 2 diabetic patients with both hypertension and microalbuminuria. Of note, glucose metabolism was indistinguishable from that in control subjects in Type 2 diabetic patients without hypertension and microalbuminuria (40.5±2.8 vs 44.4±2.8 μmol · kg lean body mass−1 · min−1). We conclude that insulin resistance in Type 2 diabetes is predominantly associated with either hypertension or microalbuminuria or with both.

Key words

Type 2 (non-insulin-dependent) diabetes mellitus insulin resistance hypertension lipids microalbuminuria 

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Copyright information

© Springer-Verlag 1993

Authors and Affiliations

  • L. Groop
    • 1
  • A. Ekstrand
    • 1
  • C. Forsblom
    • 1
  • E. Widén
    • 1
  • P. -H. Groop
    • 1
  • A. -M. Teppo
    • 1
  • J. Eriksson
    • 1
  1. 1.Fourth Department of MedicineHelsinki University HospitalHelsinkiFinland

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