Thursday, January 10, 2008

Insulin Resistance and Cardiomyopathy

An interesting abstract was published in the recent issue of the Journal of the American College of Cardiology - Insulin-Resistant Cardiomyopathy, Clinical Evidence, Mechanisms, and Treatment Options.

Increasing evidence points to insulin resistance as a primary etiologic factor in the development of nonischemic heart failure (HF). The myocardium normally responds to injury by altering substrate metabolism to increase energy efficiency. Insulin resistance prevents this adaptive response and can lead to further injury by contributing to lipotoxicity, sympathetic up-regulation, inflammation, oxidative stress, and fibrosis.

Animal models have repeatedly demonstrated the existence of an insulin-resistant cardiomyopathy, one that is characterized by inefficient energy metabolism and is reversible by improving energy use. Clinical studies in humans strongly support the link between insulin resistance and nonischemic HF.

Insulin resistance is highly prevalent in the nonischemic HF population, predates the development of HF, independently defines a worse prognosis, and predicts response to antiadrenergic therapy.

Potential options for treatment include metabolic-modulating agents and antidiabetic drugs. This article reviews the basic science evidence, animal experiments, and human clinical data supporting the existence of an "insulin-resistant cardiomyopathy" and proposes specific potential therapeutic approaches.


Too bad the researchers didn't include a carbohydrate restricted diet in their list of potential treatment options!


  1. Why would a doctor want to prescribe a life-style change when they can just give a pill?!

  2. Interesting word, lifestyle, cuz thats whats required. Changing eating habits to reduce glycemic load, is insufficient for long term success, it requires a lifestyle overhaul. People are willing and able to lose weight, may people have lost lots of weight on various and sundry plans. But if you think weight loss is the answer, you are asking the wrong question. The real question is is how to we get people to keep the weight off once they've lost it, cuz so far no diet has been proven to be any better than any other in real life. This is why doctors prescribe pills.

  3. Here's another one - an article in Emergency Medicine titled Intensive Management of Type 2 Diabetes, by Jeff Ungar. Thousands of words about treating with meds. Not a sentence about diet or carbohydrates.

  4. Anonymous10:38 PM

    I just came across your blog and I'm enjoying all the links and resources.

    I was in a car accident in 2005 and have chronic neuropathic pain - I'm currently on meds that have changed my cholesterol profile, my thyroid function and my glucose fasting numbers are now in the high normal. I'm about to do a glucose tolerance test to check my feeling that I'm now insulin resistant. I walk 3 times a week with a walking group, I take 3 intermediate level pilates classes ( an hour each!) and I'm consuming 1500 calories a day on Jenny Craig. Yet, I still weigh 80lbs more than I did! Gah. There has to be a better way.