Hyperinsulinemia in diabetes and hypertension

Citation metadata

Date: January-February 1991
From: Clinical Diabetes(Vol. 9, Issue 1)
Publisher: American Diabetes Association
Document Type: Article
Length: 2,830 words

Document controls

Main content

Abstract :

Hypertension is a significant risk factor for cardiovascular disease and stroke, while diabetes, serious in and of itself, is also associated with cardiovascular complications. Interestingly, diabetes and high blood pressure co-occur more often than can be coincidental. It seems likely that hyperinsulinemia, a condition of high insulin levels in blood, which occurs in both insulin-dependent and noninsulin-dependent diabetic patients, as well as in patients with hypertension, may be the link explaining this co-occurrence. This article explores this relationship. Many diabetics develop hypertension as kidney function declines, while diabetes among hypertensives has been attributed to the high incidence of upper-body obesity, hyperlipidemia (high blood levels of fats), and glucose intolerance. Upper-body fat is metabolically active, and fat products affect liver handling of insulin, leading to hyperinsulinemia. Raised blood insulin levels can then lead to persistent hypertension by thickening blood vessel walls. Hyperinsulinemia in nonobese hypertensives has not previously been explainable. This is now thought to be due to resistance to insulin's effects on glucose uptake and utilization by peripheral cells (muscle, fat, non-organ tissue), probably a result of several factors, which are described in this article. Regardless of these mechanisms, treatments for hypertension and diabetes need to address the two conditions' interrelatedness. Insulin sensitivity among hypertensives improves after weight reduction associated with decreased fat ingestion and regular exercise. Antihypertensive medications in diabetics should be chosen with awareness that certain of these drugs decrease insulin sensitivity and are therefore detrimental. Further research is needed about the mechanisms of these diseases, so that cardiovascular complications may be prevented. (Consumer Summary produced by Reliance Medical Information, Inc.)

Source Citation

Source Citation   

Gale Document Number: GALE|A10420941