摘要
Despite improvements in glucose, lipids and bloodpressure control, vascular complications remain the most important cause of morbidity and mortality in patients with type 1 diabetes. For that reason, there is a need to identify additional risk factors to utilize in clinical practice or translate to novel therapies to prevent vascular complications. Reduced insulin sensitivity is an increasingly recognized component of type 1 diabetes that has been linked with the development and progression of both micro- and macrovascular complications. Adolescents and adults with type 1 diabetes have reduced insulin sensitivity, even when compared to their non-diabetic counterparts of similar adiposity, serum triglycerides, high-density lipoprotein cholesterol, level of habitual physical activity, and in adolescents, pubertal stage. Reduced insulin sensitivity is thought to contribute both to the initiation and progression of macro- and microvascular complications in type 1 diabetes. There are currently clinical trials underway examining the benefits of improving insulin sensitivity with regards to vascular complications in type 1 diabetes. Reduced insulin sensitivity is an increasingly recognized component of type 1 diabetes, is implicated in the pathogenesis of vascular complications and is potentially an important therapeutic target to prevent vascular complications. In this review, we will focus on the pathophysiologic contribution of insulin sensitivity to vascular complications and summarize related ongoing clinical trials.
Despite improvements in glucose, lipids and bloodpressure control, vascular complications remain themost important cause of morbidity and mortality inpatients with type 1 diabetes. For that reason, there is aneed to identify additional risk factors to utilize in clinicalpractice or translate to novel therapies to preventvascular complications. Reduced insulin sensitivityis an increasingly recognized component of type 1diabetes that has been linked with the developmentand progression of both micro- and macrovascularcomplications. Adolescents and adults with type 1diabetes have reduced insulin sensitivity, even whencompared to their non-diabetic counterparts of similaradiposity, serum triglycerides, high-density lipoproteincholesterol, level of habitual physical activity, and inadolescents, pubertal stage. Reduced insulin sensitivityis thought to contribute both to the initiation andprogression of macro- and microvascular complicationsin type 1 diabetes. There are currently clinical trialsunderway examining the benefits of improving insulinsensitivity with regards to vascular complications in type1 diabetes. Reduced insulin sensitivity is an increasinglyrecognized component of type 1 diabetes, is implicatedin the pathogenesis of vascular complications and ispotentially an important therapeutic target to preventvascular complications. In this review, we will focus onthe pathophysiologic contribution of insulin sensitivity tovascular complications and summarize related ongoingclinical trials.
