Is Insulin Really a Heart Disease Risk Factor?

I n the U.S., the most common cause of death in adults with diabetes is coronary heart disease (1). While this is also true in adults without diabetes, heart disease is at least twice as common in patients with diabetes. The excess risk occurs with both insulin-dependent diabetes mellitus (IDDM) and non-insulin-dependent diabetes mellitus (NIDDM). Adults with diabetes are more likely than those without diabetes to have hypertension and dyslipidemia (low levels of high-density lipoprotein, high levels of triglycerides, and small dense low-density lipoprotein [LDL]), but some of the increased risk of heart disease associated with diabetes appears to be independent of these factors.

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