Abstract
Insulin has a proatherogenic effect, endogenous hyperinsulinemia is associated with a higher cardiovascular risk. The treatment by exogenous insulin may increase cardiovascular risk due to a higher risk of hypoglycemia.
This can be efficiently eliminated by using new insulin analogues. According to the ORIGIN study, the therapy by exogenous insulin analogue does not in itself increase cardiovascular risk.
However insulin as ultimum refugium for patients with type 2 diabetes mellitus is a signal of the primarily increased CV risk. Therefore it is important to make every effort to slow the progression of type 2 diabetes mellitus by all means, which can be, paradoxically, also supported by a timely and safe insulin therapy.