Functional Microangiopathy in Diabetes Mellitus

Ditzel, Jørn

doi:10.2337/diab.17.6.388

Cited by 100 publications

(52 citation statements)

References 26 publications

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“…Ervthrocyte age-related increase in hemoglobin oxygen affinity has also been reported (15 (18). In a series of papers (22)(23)(24)(25)(26)(27) attempting to account for some of the pathologic abnormalities of diabetes, Ditzel and coworkers have presented evidence to suggest that oxygen transport may be impaired in diabetics and that hypoxic injury may account for the microangiopathy. A relationship between the Hb AIC formation and tissue hypoxia is still speculative.…”

Section: Discussionmentioning

confidence: 99%

Red cell age-related changes of hemoglobins AIa+b and AIc in normal and diabetic subjects.

Fitzgibbons¹,

Koler²,

Jones³

1976

J. Clin. Invest.

168

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Section: Discussionmentioning

confidence: 99%

Red cell age-related changes of hemoglobins AIa+b and AIc in normal and diabetic subjects.

Fitzgibbons¹,

Koler²,

Jones³

1976

J. Clin. Invest.

168

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“…Very few studies that determine permeability, however, have controlled for compounding haemodynamic factors (such as flow rate, hydrostatic and colloid osmotic pressure gradients). As will be discussed further, this is particularly problematic with respect to diabetes, since other haemodynamic changes occur in the microcirculation soon after the onset of disease [6]. Early increases in blood flow and pressure have been widely reported in those organs that develop diabetic microangiopathy [7][8][9][10].…”

Section: Diabetes Is Characterised By Endothelial Dysfunctionmentioning

confidence: 99%

A Role for the Endothelial Glycocalyx in Regulating Microvascular Permeability in Diabetes Mellitus

Perrin

Harper

Bates

2007

Cell Biochem Biophys

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Diabetic angiopathy is a major cause of morbidity and mortality in diabetes mellitus. Endothelial dysfunction and associated alterations in blood flow, pressure and permeability are widely accepted phenomena in the diabetic milieu and are understood to lead to microangiopathy. Despite the clinical importance of diabetic microangiopathy, the mechanisms of pathogenesis remain elusive. In particular, much is yet to be understood about the nature of the putative increased permeability with respect to diabetes. Microvessel permeability is intrinsically difficult to measure and a surrogate (solute or solvent flux) is usually reported, the measurement of which is hampered by haemodynamic factors, such as flow rate, hydrostatic pressure gradient, solute concentration and surface area available for exchange. Very few studies describing the measurement of permeability with respect to diabetes have controlled for all these factors. As a result, the nature of the increased microvessel permeability in diabetes mellitus and indeed its causes are poorly understood. Recent studies have shown that hyperglycaemia can alter the glycocalyx structure, and parallel findings have shown that the apparent increase in permeability demonstrated in hyperglycaemia may be due to an increase in the permeability of the vessels to water, and not an increase in protein permeability, an effect attributable to altered glycocalyx. This review focuses on the current understanding of microvascular permeability in terms of the endothelial glycocalyxfibre-matrix theory, those methods used to determine permeability in the context of diabetes, and the more recent developments in our understanding of elevated microvascular permeability in the diabetic circulation.

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“…Such a prognostic indicator would be useful in view of the difficulty in correlating the conventional estimates of diabetic control, such as blood glucose levels, with the incidence of complications. Glycoproteins are also found in high concentrations in diabetic vascular lesions, particularly in the glomerulus [3,4], although there is no evidence as yet that they are deposited from the blood. Indeed there is little information available about the interrelationships of tissue and blood glycoproteins.…”

mentioning

confidence: 99%

Blood glycoprotein levels in diabetes mellitus

Jónsson

Wales

1976

Diabetologia

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Summary. Five glycoproteins have been measured in the blood of 145 diabetic patients with and without clinical evidence of complications. Patients with diabetic complications have higher glycoprotein levels particularly when expressed as a ratio to serum albumin levels. In 32 pairs of patients matched for age, sex, body weight, duration and treatment of diabetes, significantly higher haptoglobin, fibrinogen and caeruloplasmin levels were associated with the presence of diabetic complications, but blood glucose levels were not significantly different, fi-lipoprotein levels were positively correlated with age and a2-macroglobulin levels with the duration of clinical disease, but the type of antidiabetic therapy administered did not significantly alter glycoprotein levels. It is suggested that rising levels of certain glycoproteins in the blood of diabetic patients may indicate the development of diabetic vascular complications, but a prospective study is required before it can be decided whether this change predates the clinical appearance of the complications.

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Functional Microangiopathy in Diabetes Mellitus

Cited by 100 publications

References 26 publications

Red cell age-related changes of hemoglobins AIa+b and AIc in normal and diabetic subjects.

Red cell age-related changes of hemoglobins AIa+b and AIc in normal and diabetic subjects.

A Role for the Endothelial Glycocalyx in Regulating Microvascular Permeability in Diabetes Mellitus

Blood glycoprotein levels in diabetes mellitus

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