Nonglycemic effects of insulin.

Insulin affects multiple metabolic pathways in many tissues. Nonglycemic effects include inhibiting production of triglyceride-rich particles and platelet aggregation and increasing vasodilatation. In persons with normal insulin sensitivity, these actions are considered antiatherogenic. However, insulin's normal antiatherogenic actions are defective in persons who are insulin resistant, which results in hypertriglyceridemia, increased platelet aggregation, and endothelial dysfunction. Insulin therapy in patients with type 2 diabetes can lead to improved glycemic control, insulin sensitivity, lipid profile, and endothelial function and may impact the incidence and severity of cardiovascular disease.