Prevention of Vascular Complications in Diabetes Mellitus Patients: Focus on the Arterial Wall
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Published:2018-11-16
Issue:1
Volume:17
Page:6-15
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ISSN:1570-1611
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Container-title:Current Vascular Pharmacology
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language:en
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Short-container-title:CVP
Author:
Lunder Mojca1, Janić Miodrag1, Šabovič Mišo1
Affiliation:
1. Department of Vascular Diseases, University Medical Centre Ljubljana, Zaloska cesta 7; SI-1000 Ljubljana, Slovenia
Abstract
In Diabetes Mellitus (DM), hyperglycaemia and insulin resistance progressively lead to both
microvascular and macrovascular complications. Whereas the incidence of microvascular complications
is closely related to tight glycaemic control, this does not apply to macrovascular complications. Hyperglycaemia
influences many interweaving molecular pathways that initially lead to increased oxidative
stress, increased inflammation and endothelial dysfunction. The latter represents the initial in both types
of vascular complications; it represents the “obligatory damage” in microvascular complications development
and only “introductory damage” in macrovascular complications development. Other risk factors,
such as arterial hypertension and dyslipidaemia, also play an important role in the progression of
macrovascular complications. All these effects accumulate and lead to functional and structural arterial
wall damage. In the end, all factors combined lead to the promotion of atherosclerosis and consequently
major adverse cardiovascular events. If we accept the pivotal role of vascular wall impairment in the
pathogenesis and progression of microvascular and macrovascular complications, treatment focused
directly on the arterial wall should be one of the priorities in prevention of vascular complications in
patients with DM. In this review, an innovative approach aimed at improving arterial wall dysfunction is
described, which may show efficacy in clinical studies. In addition, the potential protective effects of
current treatment approaches targeting the arterial wall are summarised.
Publisher
Bentham Science Publishers Ltd.
Subject
Cardiology and Cardiovascular Medicine,Pharmacology
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