Impact of Diabetes on Vasculature: Focus on Nervous System

Abstract

Chronic complications of diabetes mellitus represent a major cause of morbidity and mortality among those affected and have an enormous impact on society as a whole. Although these complications manifest as a number of clinically distinct syndromes, the pathology underlying them may be very similar, if not identical. Endothelial dysfunction leading to microcirculatory insufficiency and functional ischemia of tissues are proposed to play a pivotal role in the process of their development and progression. Diabetic complications affecting the nervous system occur not infrequently and may have disastrous consequences. This article reviews diabetic complications affecting central and peripheral nervous systems, focusing on similarities in their underlying microvascular pathology and discussing aspects of potentially successful therapeutic interventions. In addition, the article draws a parallel between microvascular dysfunction observed in persons with overt diabetes and those at risk for it.

Chromium-Picolinate Therapy in Diabetes Care: Individual Outcomes Require New Guidelines and Navigation by Predictive Diagnostics

“…The reduced bioavailability of vasodilator nitric oxide (NO) and increased NO degradation by ROS (13, 14) result in endothelial dysfunction - main initiating event leading to various chronic complications such as disturbancies in microcirculation, retinopathy, angiopathy, nephropathy, poly-neuropathy, cardiomyopathy, etc. (Fig.…”

Population pharmacokinetics of empagliflozin, a sodium glucose cotransporter 2 inhibitor, in patients with type 2 diabetes

“…Type 2 diabetes mellitus (T2DM) is a chronic disease that affects an estimated 285 million people worldwide, and is characterized by hyperglycemia as a result of insulin resistance and impaired insulin secretion . Hyperglycemia can cause complications in many organ systems, including the nervous and vascular systems …”

“…1 Hyperglycemia can cause complications in many organ systems, including the nervous and vascular systems. [2][3][4] Approaches to lower blood glucose in patients with T2DM include diet and exercise modifications, with the addition of oral anti-hyperglycemic medications and insulin, if needed. In the UK Prospective Diabetes Study (UKPDS), intensive treatment with metformin, sulfonylureas, or insulin resulted in only a limited improvement in glycemic control over 10 years compared with dietary modification alone, with a significant loss in glycemic control over time.…”

Chromium-Picolinate Therapy in Diabetes Care: Molecular and Subcellular Profiling Revealed a Necessity for Individual Outcome Prediction, Personalised Treatment Algorithms & New Guidelines

“…The increased oxidative and nitrosative stress, as a result of hyperglycemic episodes, is known to complicate even well controlled cases of diabetes, thereby resulting in micro- and macrovascular outcomes (10). The reduced bioavailability of vasodilator nitric oxide (NO) and increased NO degradation by ROS (11, 12) result in endothelial dysfunction - main initiating event leading to various chronic complications such as retinopathy, angiopathy, nephropathy, poly-neuropathy, cardiomyopathy, etc. (Figure 1).…”