Issue 125 Item 12 Type 2 Diabetes Is Associated With Myocardial Insulin Resistan

Type 2 diabetes is specifically associated with myocardial insulin resistance. Type 2 diabetes is specifically associated with myocardial insulin resistance that is independent of coronary artery disease and proportional to skeletal muscle and whole-body insulin resistance.

Dr. Patricia Iozzo, at the Imperial College of Science, Technology and Medicine, in London, England, and colleagues studied a case-control series of 55 male non-diabetics and type 1 or type 2 diabetics, with or without angiographically documented coronary artery disease.

Using positron emission tomography, the researchers measured baseline blood flow and insulin-stimulated glucose uptake during euglycemic and physiological hyperinsulinemia in skeletal muscle and normally contracting myocardium of the subjects.

They found that skeletal muscle glucose uptake was reduced in association with both coronary artery disease and type 2 diabetes.

In regions with normal baseline perfusion, insulin-mediated myocardial glucose uptake was reduced in both type 2 diabetics, who were free of coronary artery disease, and in coronary artery disease patients, who were free of diabetes – as compared with healthy control subjects or type I diabetics without coronary artery disease, the investigators reported.

Neither basal skeletal muscle nor basal myocardial blood flow differed across the groups. Both skeletal muscle and myocardial insulin resistance were found directly related to whole-body insulin resistance.

"We conclude that type 2 diabetes is specifically associated with myocardial insulin resistance that is independent of and non-additive with angiographic coronary artery disease and proportional to skeletal muscle and whole-body insulin resistance," the researchers wrote. Diabetes 2002; 51: 3020-3024