Comparison of the effects of intensive insulin treatment modalities on cardiovascular biomarkers in type 1 diabetes mellitus

Abstract Aim To evaluate effects of intensive insulin treatment modalities on cardiovascular biomarkers in patients with type 1 diabetes mellitus (T1DM). Materials and methods A total of 25 patients with T1DM receiving intensive insulin therapy either in the form of continuous insulin pump (IP group; n  = 13) or as multiple daily injections (MDI group; n  = 12) and 13 controls (control group, n  = 13) were included. Data on demographics, anthropometrics, diabetes history, and laboratory findings including glycemic and lipid parameters, and cardiovascular biomarkers [C-reactive protein (mg/dL), homocysteine (μmol/L), fibrinogen (mg/dL), oxidized LDL (ng/dL), PAI-1 (ng/mL), MCP-1 (pg/mL) and VEGF (pg/mL)] were recorded in each group. Correlation of cardiovascular biomarkers to other parameters was also evaluated in T1DM patients. Results Apart from significantly higher mean (SD) values for HbA1c [6.1 (0.3) vs. 5.6 (0.5)% (43 (3) vs. 38 (5) mmol/mol), p p r  = −0.615, p  = 0.025), and HDL-c to CRP ( r  = −0.685, p  = 0.010) and VEGF ( r  = −0.678, p  = 0.011) was noted in IP group, whereas positive correlation of PAI-1 to diabetes age ( r  = 0.805, p  = 0.002) and treatment duration was noted in MDI group. Conclusion Our findings in a cohort of T1DM patients with optimal glycemic control revealed that intensive insulin therapy was not associated with an increase in atherosclerotic markers in T1DM, regardless of whether continuous IP infusion or MDIs was administered.