Diabetes‐associated macrovasculopathy: pathophysiology and pathogenesis

Abstract

The complications associated with diabetic vasculopathy are commonly grouped into two categories: microvascular and macrovascular complications. In diabetes, macrovascular disease is the commonest cause of mortality and morbidity and is responsible for high incidence of vascular diseases such as stroke, myocardial infarction and peripheral vascular diseases. Macrovascular diseases are traditionally thought of as due to underlying obstructive atherosclerotic diseases affecting major arteries. Pathological changes of major blood vessels leading to functional and structural abnormalities in diabetic vessels include endothelial dysfunction, reduced vascular compliance and atherosclerosis. Besides, advanced glycation end product formation interacts with specific receptors that lead to overexpression of a range of cytokines. Haemodynamic pathways are activated in diabetes and are possibly amplified by concomitant systemic hypertension. Apart from these, hyperglycaemia, non-enzymatic glycosylation, lipid modulation, alteration of vasculature and growth factors activation contribute to development of diabetic vasculopathy. This review focuses on pathophysiology and pathogenesis of diabetes-associated macrovasculopathy.

Effects of Grape Seed Proanthocyanidin Extracts on Aortic Pulse Wave Velocity in Streptozocin Induced Diabetic Rats

“…Figure 1B shows the results of comparisons of FBG findings among groups C1, C2, DM, and DMT. The FBG of the diabetic rats was significantly higher than that of the control rats at 0, 4,8,12,16,20, and 24 weeks (P < 0:01), but GSPEs did not decrease FBG at 0, 4,8,12,16,20, and 24 weeks (P > 0:05). The results for body weights and FBG by three-way ANOVA are summarized in Table 1.…”

“…Pathological changes in major blood vessels leading to functional and structural abnormalities in diabetic vessels include endothelial dysfunction, reduced vascular compliance, and atherosclerosis. 4) Therefore, it is important to identify subclinical manifestations of vascular diseases so that the effectiveness of early intervention can be assessed. One of the manifestations of subclinical vascular disease is arterial stiffness, which represents a loss of compliance and elasticity within large arteries.…”

Risk of cardiovascular disease and mortality in overweight and obese patients with type 2 diabetes: an observational study in 13,087 patients

“…Other variables (e.g. disturbed fibrinolysis, endothelial dysfunction and low-grade inflammation) are also most likely to be involved in the causal pathways between overweight and obesity and increased risk of CHD [33].…”

Adherence to treatment among type 2 diabetes mellitus patients visiting a tertiary care hospital in Mangalore

“…India has an estimated population of 63 million diabetic subjects 3 . In diabetes, macrovascular disease is the commonest cause of mortality and morbidity and is responsible for high incidence of vascular diseases such as stroke, myocardial infarction and peripheral vascular diseases 4 . Lifestyle modifications and pharmacotherapy plays an important role in the prevention of these complications.…”