Higher insulin doses were associated with adverse trends in several cardiometabolic risk factors, even after multivariable adjustment, but not with incident cardiovascular disease (CVD) outcomes. This according to the recent Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications (DCCT/EDIC) study, which demonstrated the beneficial effects of intensive therapy on atherosclerosis and clinical CVD outcomes. 1,441 participants with type 1 diabetes were randomly assigned to intensive or conventional diabetes therapy during the DCCT. After an average of 6.5 years of follow-up, 96% of the surviving cohort enrolled in the EDIC observational study, which included annual visits with detailed medical history, physical examination, and laboratory testing. Researchers found:

• Higher insulin doses were significantly associated with a less favorable cardiometabolic risk profile (higher BMI, pulse rate, triglycerides, and lower HDL cholesterol) with the exception of lower diastolic blood pressure and lower LDL cholesterol.
• In a minimally adjusted model, a 0.1 unit/kg body weight/day increase in insulin dose was associated with a 6% increased risk of any CVD.
• However, the association with insulin dose was no longer significant after adjustment for other CVD risk factors.