Time from diagnosis of type 2 diabetes to initiation of insulin therapy is related to carotid artery intima-media thickness.

To investigate the association between time from diagnosis of type 2 diabetes to initiation of insulin therapy (pre-exogenous insulin period) and intima-media thickness (IMT) of the common carotid artery (CCA), a cross-sectional analysis was conducted among 98 males and 193 females (90% Hispanic) with type 2 diabetes, aged 30-70 years old. The association between the pre-exogenous insulin period and the primary outcome was examined in men and women using analysis of covariance (ANCOVA) with adjustment for current age, duration of insulin therapy, low-density lipoprotein (LDL) cholesterol, systolic blood pressure and hemoglobin A1c. The pre-exogenous insulin period was significantly and linearly associated with mean IMT of the CCA in men. In women, the linear trend was not significant while a significant quadratic trend was noted across three categories of the pre-exogenous insulin period (0-5, 6-10, 11-24 years). Longitudinal data are needed to determine the effect of early initiation of insulin therapy on the progression of subclinical atherosclerosis among persons with diabetes.