Photo of Hans Arnqvist

Hans Arnqvist

Studies of vascular metabolism and diabetes

The presence and function of insulin and IGF-I receptors is studied in endothelial and vascular smooth muscle cells. Both in human endothelial cells from micro- and macro-vessels and in human vascular smooth muscle cells IGF-I receptors are several fold more abundant than insulin receptors.

We have shown that insulin and IGF-I receptors also occur as hybrid IGF-I/insulin receptors in human endothelial and vascular smooth muscle cells. The physiological and patophysiological importance of these observations are now investigated.

In clinical studies we have measured circulating IGF-I and other components of the IGF-system in patients with type 1 diabetes. In type 1 diabetic patients with long duration circulating IGF-I is 30-40% lower than in healthy controls and is not related to glycaemic control. The abnormalities in the IGF-system occur even if the patients are normoglycaemic.

We have shown that in patients with residual endogenous insulin secretion the IGF-system is almost normal while abnormalities are found in patients lacking endogenous insulin secretion. The clinical consequences of the abnormalities in the IGF-system are currently under investigation.

Our current view of the IGF-system in diabetes is shown in the figure below. Insulin deficiency in diabetes causes hyperglycaemia but also changes in the IGF-system. The delivery of insulin through the portal vein to the liver regulate growth hormone receptors and thereby IGF-I production as well as production of IGFBP-1.

Our data suggest that subcutaneous insulin treatment which is the routine used today is insufficient and that insulin delivery through the portal vein is needed to normalize the IGF-system. The IGF-I receptor is abundant in vascular cells and these cells respond to low physiological levels of IGF-I. Low circulating IGF-I may therefore be of particular importance for vascular tissue.



Hans Arnqvist, Johnny Ludvigsson, Maria Nordwall (2024) Early increase in HbA1c trajectory predicts development of severe microangiopathy in patients with type 1 diabetes: the VISS study BMJ Open Diabetes Research & Care, Vol. 12, Article e003917 Continue to DOI


Hans Arnqvist, Per Leandersson, Anna Spångeus (2023) Vitamin D status in longstanding type 1 diabetes and controls. Association with upper extremity impairments Upsala Journal of Medical Sciences, Vol. 128 Continue to DOI
Lee Ti Davidson, Ulf Martin Schilling, Hans J. Arnqvist, Fredrik H. Nyström, Simona Ioana Chisalita (2023) Association of physiological stress markers at the emergency department to readmission and death within 90 days: a prospective observational study Upsala Journal of Medical Sciences, Vol. 128, Article e9300 Continue to DOI


Lee Ti Davidson, Emilia Gauffin, Preben Henanger, Maciej Wajda, Daniel Wilhelms, Bertil Ekman, Hans Arnqvist, Martin Schilling, Ioana Simona Chisalita (2022) Admission of patients with chest pain and/or breathlessness from the emergency department in relation to risk assessment and copeptin levels - an observational study Upsala Journal of Medical Sciences, Vol. 127, Article e8941 Continue to DOI
Hans Arnqvist, Malin C. Westerlund, Mats Fredrikson, Johnny Ludvigsson, Maria Nordwall (2022) Impact of HbA(1c) Followed 32 Years From Diagnosis of Type 1 Diabetes on Development of Severe Retinopathy and Nephropathy: The VISS Study Diabetes Care, Vol. 45, p. 2675-2682 Continue to DOI