Insulin therapy in people who have dysglycemia and type 2 diabetes mellitus: Can it offer both cardiovascular protection and beta-cell preservation?

Dysglycemia, an elevated glucose level that extends into the diabetes mellitus range, is a recognized risk factor for cardiovascular disease. Glucose levels rise because of insufficient insulin caused by insulin resistance or insulin deficiency. Elevated glucose and insufficient insulin effects are implicated in the pathogenesis of cardiovascular disease. Emerging data suggest that glucose lowering with insulin may reduce safely the risk for cardiovascular disease and preserve beta-cell function. Large, controlled international trials are testing the hypothesis that insulin therapy may have cardiovascular benefits.