Many people with diabetes — both type 1 and type 2 — are aware that their condition puts them at higher risk for heart disease and related problems. But they might not be aware that their diabetes also puts them at higher risk for complications if they undergo angioplasty, a common procedure in which constricted arteries are opened up and stabilized with a tube known as a stent.
Investigators at the Joslin Diabetes Center in Boston designed an experiment using mice to study what might be happening in the body to cause this higher risk of complications. Their results, published in the journal Nature Communications, suggest that insulin exposure plays a major role in a common complication of angioplasty.
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As described in a Joslin press release, the researchers were interested in exploring what leads to a complication called restenosis, in which the treated blood vessel clogs up again after an angioplasty. They already knew that insulin and a similar hormone, insulin-like growth factor (IGF), stimulate the growth and movement of cells in blood vessels that play a major role in restenosis, known as vascular smooth muscle cells (VSMCs).
The researchers found that insulin plays an outsize role in restenosis by looking at mice with the equivalent of type 2 diabetes, genetically engineering them to get rid of receptors in their VSMCs for either insulin or IGF. When the insulin receptor in these blood vessel cells was deleted — meaning that insulin couldn’t enter the cells — restenosis in the mice got better. When the IGF receptor was deleted, on the other hand, restenosis in the mice got worse.
This research points not only to the mechanism behind a widespread problem in people with diabetes who undergo angioplasty, but also a potential solution: coating stents used in the procedure with drugs that inhibit insulin receptors in that area of the blood vessel.
“Stent failures commonly occur within three to six month,” notes study author George L. King, MD, Joslin Senior Vice President and Chief Scientific Officer, in the press release. “So if such stents were effective for that period, stent failure could be reduced significantly for people with diabetes or insulin resistance.”
Want to learn more about diabetes and heart health? Read “Lower Your Risk of Heart Disease” and “Fight Off Heart Disease With These Five Heart-Healthy Foods.”
A freelance health writer and editor based in Wisconsin, Phillips has a degree in government from Harvard University. He writes on a variety of topics, but is especially interested in the intersection of health and public policy.