Clinical impact of insulin resistance syndrome in cardiovascular diseases and its therapeutic approach.

In subjects with coronary artery diseases (obstructive and vasospastic angina pectoris (AP)) who have no diabetes, hypertension, obesity and physical inactivity, insulin sensitivity was significantly reduced with compensated hyperinsulinemia on OGTT. Insulin resistance significantly correlated with coronary atherosclerosis score. In vasospastic AP (VAP), those who fulfilled more than 3 risk factors out of 5 (hyperinsulinemia, obesity, glucose intolerance, hypertension, dyslipidemia) consist of 70 and 40% for smokers and nonsmokers respectively.

3,5,3'-Triiodothyronine regulates insulin level in the circulation following glucose ingestion in humans.

To clarify the relationship between the 3,5,3'-triiodothyronine (T3) response and the insulin response after glucose ingestion in humans, serum T3, immunoreactive insulin (IRI), C-peptide immunoreactivity (CPR), nonesterified fatty acid (NEFA) and plasma glucose levels were measured in 11 nonobese inpatients with normal glucose tolerance after oral 75 g glucose tolerance test. Ingestion of the glucose solution significantly increased serum T3 levels from 120.1 +/- 4.

The effects of insulin on the cardiovascular system in patients with coronary heart disease.

In order to clarify the effects of insulin on the cardiovascular system in patients with and without coronary heart disease (CHD), we studied the changes of electrocardiogram (ECG), blood pressure, pulse rate, along with those of blood glucose, free fatty acid, immunoreactive insulin, cortisol and potassium during insulin tolerance test (ITT). The presence or absence of CHD was verified by the coronary angiography and various stress testings beforehand. In patients with CHD, ischemic ST-T wave changes were recorded following the increment of double product after insulin injection and these changes were quite similar to those recorded during exercise test.

Coma preceded by severe dysphagia in type II diabetes mellitus.

A 62-year-old man with 11 years' duration of type II diabetes was hospitalized because of non-ketotic diabetic coma. He had never noted any symptoms of swallowing difficulty until 3 days before admission when they developed gradually and he became comatous. He had never received special medication such as diuretics except anticonvulsants.