Sobel BE, Hardison RM, Genuth S et al.; BARI 2D Investigators. Circulation 2011;124:695–703.
The present study assessed differences in the profile of circulating levels of fibrinolysis and inflammation biomarkers between two different strategies – an insulin-sensitizing (IS) strategy and an insulin-providing (IP) strategy – for glycemic control among patients with type 2 diabetes mellitus and clinically stable, angiographically documented coronary artery disease. Compared with IP, IS decreased compensatory hyperinsulinemia, led to a change in biomarker profiles indicative of constrained fibrinolysis, and diminished the intensity of the systemic inflammatory state. The directional differences in biomarker profiles with IS compared with IP were also consistent over time.
Patients with type 2 diabetes mellitus (DM) and angiographically proven coronary artery disease have a greater incidence of adverse cardiovascular events such as myocardial infarction and death. This is because of a complex vasculopathy and is also thought to result in part from augmented inflammation and impaired fibrinolysis. The aim of the present study was to assess differences in the profile of circulating levels of fibrinolysis and inflammation biomarkers between two different strategies, an insulin-sensitizing (IS) strategy and an insulin-providing (IP) strategy for glycemic control.