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Endothelial dysfunction is clearly mechanism that good
explain the presence of microalbuminuria. This is also play a role in the etiology of
coronary heart disease. Insulin has major effects on the endothelium producing
vasodilatation mediator through the action of nitric oxide. Insulin resistance subjects,
such those with obesity or with Type 2 Diabetes demonstrated resistance to the
vasodilating action of insulin and this failure of insulin to produce an increased in
muscle blood flow, may be responsible through failure of delivery of insulin and glucose
for up to 40% of the resistance to the action of insulin seen in this insulin resistance
subjects. |