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Diabetic Macroangiopathy

Angiopathy - Wikipedia

Angiopathy - Wikipedia

Angiopathy is the generic term for a disease of the blood vessels ( arteries , veins , and capillaries ). [1] The best known and most prevalent angiopathy is diabetic angiopathy , a common complication of chronic diabetes . There are two types of angiopathy: macroangiopathy and microangiopathy . In macroangiopathy, atherosclerosis and a resultant blood clot forms on the large blood vessels, sticks to the vessel walls, and blocks the flow of blood . Macroangiopathy may cause other complications, such as ischemic heart disease , stroke and peripheral vascular disease which contributes to the diabetic foot ulcers and the risk of amputation. In microangiopathy, the walls of the smaller blood vessels become so thick and weak that they bleed , leak protein , and slow the flow of blood through the body. The decrease of blood flow through stenosis or clot formation impairs the flow of oxygen to cells and biological tissues (called ischemia ) and leads to cellular death ( necrosis and gangrene , which in turn may require amputation ). Thus, tissues which are very sensitive to oxygen levels, such as the retina , develop microangiopathy and may cause blindness (so-called proliferative diabetic retinopathy ). Damage to nerve cells may cause peripheral neuropathy , and to kidney cells, diabetic nephropathy ( Kimmelstiel-Wilson syndrome ). Continue reading >>

Macroangiopathy - An Overview | Sciencedirect Topics

Macroangiopathy - An Overview | Sciencedirect Topics

Simerpreet Bal, ... Andrew M. Demchuk*, in Handbook of Clinical Neurology , 2014 Imaging small vessel abnormalities in diabetes mellitus Use of transcranial Doppler in diabetic patients with chronic cerebrovascular disease In contrast to macroangiopathy, assessed with many invasive and noninvasive investigations discussed above, cerebral microangiopathy involving small perforating arteries contributes to lacunar infarction but has no specific diagnostic tool. TCD may provide indirect assessment of the microvasculature by the pulsatility index (PI), which is calculated from the difference between peak systolic velocity and end-diastolic velocity. Increased PI has been associated with the duration of DM, old age (>60 years), hypertension, intracranial atherosclerosis, vascular dementia, and small vessel disease (Hassler et al., 1988; Foerstl et al., 1989; Cho et al., 1997; Lee et al., 2000; Kidwell et al., 2001). The PI is postulated to reflect the vascular resistance distal to the examined artery. Therefore, disease or dysfunction of distal small intracranial perforating arteries may alter the PI of upstream larger intracranial artery such as the MCA. Indirect findings of increased PI is more relevant when there is other evidence of DM-related microangiopathic disease such as retinopathy or nephropathy (Lippera et al., 1997; Lee et al., 2000). In a TCD study comparing cerebral hemodynamics in type 2 diabetic patients of disease duration greater than 5 years, flow velocities (Vm) and PI was higher in comparison to age-matched controls. Lacunar infarcts in an otherwise asymptomatic diabetic population have revealed increased PI in intracranial vessels shown on TCD (Tkac et al., 2001). Further studies using long-term serial follow-up TCD exams may clarify the temporal chan Continue reading >>

Relationship Between Free Fatty Acid Spectrum, Blood Stasis Score, And Macroangiopathy In Patients With Type 2 Diabetes Liu Dl, Chu Sf, Li Hl, Zhao Hx, Liu Xm, Qu X, Zhou Yn, Chen Z, Zhang Xw - World J Tradit Chin Med

Relationship Between Free Fatty Acid Spectrum, Blood Stasis Score, And Macroangiopathy In Patients With Type 2 Diabetes Liu Dl, Chu Sf, Li Hl, Zhao Hx, Liu Xm, Qu X, Zhou Yn, Chen Z, Zhang Xw - World J Tradit Chin Med

Source of Support: None, Conflict of Interest: None Objective: Our aim was to investigate the correlation between free fatty acid (FFA) spectrum, blood stasis (BS) score, and macroangiopathy in type 2 diabetic patients with or without BS, as well as the possible relationship between BS and lipotoxicity. Methods: A total of 50 type 2 diabetes (T2D) patients with or without BS were enrolled from June to December 2014 in Shenzhen Traditional Chinese Medicine (TCM) Hospital, with 25 patients allocated to each of two groups. Basic information, BS score, blood glucose, blood lipids, etc., were measured for each patient. In addition, we tested the levels of interleukin (IL)-6, tumor necrosis factor (TNF-), and IL-18 with enzyme-linked immunosorbent assay. The macroangiopathy status of patients in the two groups was examined by color ultrasound and all factors related to BS scores were analyzed. Gas chromatography-mass spectrometry was used to explore the difference in the serum FFA spectra between the two different groups. In addition, the relationship between FFA spectra, BS scores, and macroangiopathy was analyzed. Results: BS scores, total cholesterol (TC), total triglyceride (TG), low-density lipoprotein cholesterol, IL-6, TNF-, IL-18, carotid and femoral artery plaque, carotid intima-media thickness, carotid plaque area, and femoral artery plaque area were all significantly increased in T2D patients with BS syndrome (P < 0.05). A positive correlation was observed between age, duration of diabetes, carotid intima-media thickness, carotid plaque area, femoral artery plaque area, and BS score (P < 0.05). A total of 21 fatty acids were found in the serum, and total FFA (TFFA), saturated fatty acid (SFA), lauric acid (C12:0), palmitic acid (16:0), stearic acid (C18:0), arachi Continue reading >>

Renal And Macro-angiopathy Outcomes Up With Bp

Renal And Macro-angiopathy Outcomes Up With Bp

You have allowed cookies to be placed on your computer. This decision can be reversed. Renal and Macro-angiopathy Outcomes Up With BP Blood pressure of <120/70 mm Hg linked to lower risk of chronic kidney disease, macroalbuminuria For patients with type 1 diabetes, blood pressure (BP) of <120/70 mm Hg is associated with a substantially reduced risk of adverse renal outcomes, according to a study published online Nov. 21 in Diabetes Care. Elaine Ku, M.D., from the University of California in San Francisco, and colleagues compared BP levels and their association with the risk of renal outcomes among 1,441 participants with type 1 diabetes aged 13 to 39 years who had been randomized to receive intensive versus conventional glycemic control. Time-updated systolic BP (SBP) and diastolic BP (DBP) were the exposures of interest. The researchers identified 84 cases of stage III chronic kidney disease (CKD) and 169 cases of macroalbuminuria during a median follow-up of 24 years. Compared with SBPs between 130 and 140 mm Hg, SBP in the <120 mm Hg range correlated with a 0.59 times risk of macroalbuminuria and a 0.32 times risk of stage III CKD, in adjusted models. Compared with DBPs between 80 and 90 mm Hg, DBP in the <70 mm Hg range correlated with a 0.73 times risk of macroalbuminuria and a 0.47 times risk of stage III CKD. There was no interaction between BP and glycemic control strategy. "A lower BP (<120/70 mm Hg) was associated with a substantially lower risk of adverse renal outcomes, regardless of the prior assigned glycemic control strategy," the authors write. The Joint National Committee and American Diabetes Association guidelines currently recommend a blood pressure (BP) target of <140/90 mmHg for all adults with diabetes, regardless of type (13). However, evidence Continue reading >>

Treatment Of Peripheral Diabetic Macroangiopathy With Sulodexide (vessel Due F)

Treatment Of Peripheral Diabetic Macroangiopathy With Sulodexide (vessel Due F)

> Treatment of peripheral diabetic macroangiopathy with Sulodexide (Vessel Due F) Treatment of peripheral diabetic macroangiopathy with Sulodexide (Vessel Due F) Author:K. Vizev, M. Radeva, D. Tcharactchiev, D. Koev,Clinical Center of Endocrinology and Gerontology, Medical University, Sofia Changes in the endothelium and blood coagulation play an important role in the pathogenesis of diabetic vascular complications. It is known that an increased platelets activity, predisposition to thrombosis, decreased fibrinolysis and impaired endothelial function are present in diabetes mellitus. Glucosoaminoglycans in the vessels wall are diminished and this results in an increased permeability and a decreased electronegative charge of the thickened basal membrane with consequent easier transport of serum proteins through the membrane. Sulodexide (Vessel Due F) contains glucosoaminoglycans (80 % heparin-like substance and 20% dermatan sulphate) which have antithrombotic, anticoagulant and fibrinolytic effects. Besides, they strengthen the endothelium, normalize the blood viscosity and have antiatherogenic actions. Results from a clinical trial of Sulodexide (Vessel Due F) in 15 patients witd non-insulin-dependent diabetes mellitus in a state of good glycaemic control and a peripheral diabetic neuropathy are presented. After an informed consent of the patients Sulodexide was administered as an intramuscular injection once daily for 10 days followed by an oral administration of 1 tablet twice daily. Patients' complaints, blood pressure, blood glucose, serum lipids, haemocoagulation variables, Doppler sonography, exercise tolerance while walking on the treadmill and radionuclide angiography of the lower limbs were followed up. For evaluation of possible side effects blood count, seru Continue reading >>

Irocket Learning Module: Pathological Complications Of Diabetes Mellitus

Irocket Learning Module: Pathological Complications Of Diabetes Mellitus

Pathological Complications of Diabetes Mellitus The most important long-term effects of diabetes mellitus are manifested principally in the cardiovascular system in the form of accelerated atherosclerosis and hyaline arteriosclerosis (diabetic macroangiopathy) and of specific capillary lesions (diabetic microangiopathy). Cardiovascular disease is the underlying cause of death of nearly 60 percent of deaths among people with diabetes. Manifested by increased incidence and severity of: Coronary artery disease: myocardial infarction Cerebrovascular accidents: strokes (infarcts and intracerebral hemorrhage) Peripheral ischemic arterial disease: especially, lower extremities Arteriolar nephrosclerosis: decreased renal function Diabetic microangiopathy develops after 10-15 years of the disease. Lesions occur at the level of capillaries and consist of increased accumulation of capillary basement membrane material, causing distortion, abnormal permeability, and eventually occlusion of the capillaries. The exact mechanism for hyperglycemic induced extracellular matrix protein synthesis leading to basement membrane thickening is presently unclear. The exact role of nonenzymatic glycosylation of proteins and basement membrane thickening in chronic diabetic states is also unclear. Click on an image below to view a larger version, in a new browser window. Characterized by diffuse thickening of glomerular capillary basement membranes and increased amount of mesangial matrix with mild mesangial cell proliferation (mesangial enlargement). Glomerular changes always begin in the vascular stalk. The affected glomeruli eventually develop obliterative diabetic glomerulosclerosis. These changes are seen in at least 40% of diabetic patients after more than 10 to 20 years. Nodular Glomeroscle Continue reading >>

P-151: Impact Of 24h-haemodynamic Variability On Diabetic Macroangiopathy

P-151: Impact Of 24h-haemodynamic Variability On Diabetic Macroangiopathy

1- To assess the variability of arterial blood pressure and heart rate in a diabetic population with and without macrovascular damage. 2- To determine its correlation with age, time of evolution, metabolic control. Patients included in the study n=27; 15 men and 12 women; ages 43 to 81 (66 +/- 9,43); the time of evolution: 1 to 46 years (11,5+/-10)] fulfilled the WHO criteria for type 2 diabetes mellitus. Macroangiopathy was assessed based on clinical manifestations, electrocardiography, plain X-rays, carotid artery Doppler ultrasonography [Macro+ (n=18 / 66,66 %); Macro- (n=9 / 33,33 %)]. Metabolic control (basal glycemia and HbA1c). Holter blood pressure monitor (Spacelabs 90207). Statistical analysis: Contingency tables (Fisher's exact test). Mann-Whitney test. 1- Systolic arterial blood pressure variability (Macro+ versus Macro-): (16,25 +/- 3.84 versus 9,5 +/- 1.24 mmHg)(p < 0,01). 2- Heart rate variability (Macro+ versus Macro-): (7.94 +/- 2.6 versus 10.10 +/- 2.28 bpm)(p < 0,02) 3- No correlation of the parameters evaluated with age and time of evolution was found. 1- Systolic arterial blood pressure variability, and not diastolic arterial blood pressure variability, is a associated to macroangiopathy in type 2 diabetes mellitus. 2- Reduced heart rate variability in diabetic patients with macroangiopathy could be accounted by related autonomic neuropathy. Continue reading >>

Macroangiopathy In Diabetes Mellitus

Macroangiopathy In Diabetes Mellitus

In patients with diabetic angiopathy until today, no histological nor histochemical evidence has been found to define a specific type of diabetic arteriopathy. Consequently, diabetic arteriosclerosis is considered as a more serious form of atherosclerosis characterized by its premature onset. Hyperglycemia is assumed to be the crucial pathophysiological cause of the development of macro- and microangiopathy in diabetes mellitus. Apparently, hyperglycemia has a direct toxic influence on the arterial wall by increased accumulation of irreversible glycosylation end products, and secondly, it provokes endothelial dysfunction. The frequently occurring ulcerations of the diabetic foot are primarily caused by neuropathy; however, peripheral vascular disease (PVD) is often associated. The risk of suffering from PVD in diabetic patients is approximately four-fold. Usually, the distal segments of the lower leg arteries are concerned, where reconstructive intervention is complicated or even impossible. Diabetes is considered as an independent risk factor for cardio- and cerebrovascular diseases with almost twice as high rates for recurrent myocardial infarction, and a 3.7 fold higher relative risk for stroke in diabetic, compared to non-diabetic patients. This review looks at the correlations between hyperglycemia and arteriosclerosis, but also the treatment options in diabetic patients. Until now, there is no evidence for an association between an optimal control of blood glucose levels and a decrease in the risk of coronary heart disease, stroke, or PVD. In contrast, an attenuation of microvascular lesions is achieved by stringent control of blood glucose levels. Thus, although the development of macroangiopathy may not be significantly influenced, the conduction of a stringent Continue reading >>

Peripheral Neuropathy And Macro-angiopathy In Diabetics With Foot Ulcers In Port Harcourt, Nigeria | Unachukwu | Nigerian Journal Of Orthopaedics And Trauma

Peripheral Neuropathy And Macro-angiopathy In Diabetics With Foot Ulcers In Port Harcourt, Nigeria | Unachukwu | Nigerian Journal Of Orthopaedics And Trauma

Nigerian Journal of Orthopaedics and Trauma Log in or Register to get access to full text downloads. Peripheral Neuropathy And Macro-Angiopathy In Diabetics With Foot Ulcers In Port Harcourt, Nigeria OBJECTIVES: The study was aimed to determine the prevalence of peripheral neuropathy and macro-angiopathy among adult diabetic subjects with foot ulcer/gangrene in Port Harcourt, Nigeria. METHODS AND MATERIALS: Fifty-one (51) consecutive diabetics with foot ulcer/gangrene admitted into the medical wards of the University of Port Harcourt Teaching Hospital (UPTH) between January 2002 and April 2003, were evaluated for symptom and signs of peripheral neuropathy. Symptoms and signs grades were assigned using a modification of the scoring system developed by Young et al (1993). Peripheral macro-vascular disease was assessed by palpation of the dorsalis pedis and posterior tibial arteries. RESULTS: Thirty eight (74.5%) of the subjects had symptoms of peripheral neuropathy of mild to severe grades, and forty four (86.3%) had signs of neuropathy of mild to severe grades. Seven (13.7%) of the subjects had neither symptoms nor signs, while six (11.8%) had asymptomatic peripheral neuropathy. Overall, symptom and sign ratings showed poor agreement (Kappa Coefficient=0.335). The mean duration of diabetes was directly related only to symptoms grade (ANOVA p-value=0.02). Eighteen (35.3%) of the subjects had absence of either the dorsalis pedis or the posterior tibial pulses in the affected foot. Of these, 15 (83.3%) also had co-existing signs of peripheral neuropathy; the rest 3 (16.7%) had absent pulses only. CONCLUSIONA high prevalence of peripheral neuropathy in diabetics with foot ulcers/gangrene was recorded. The study also revealed that peripheral vascular disease alone may not pl Continue reading >>

Diabetes And Diabetic Complications

Diabetes And Diabetic Complications

The Maillard reaction and diabetes mellitus (Contribution from Dr Alejandro Gugliucci MD, PhD) Diabetes mellitus, a condition characterized mainly by a quantitative deficiency in insulin secretion or a resistance to insulin action, is estimated to afflict 8% of the population. This creates a huge economic burden related for the most part to the management of its complications, which are micro and macroangiopathic in nature. Microangiopathy, the microvessel disease in diabetes, includes retinopathy, nephropathy, and neuropathy and in type 1 patients the first signs of these complications may develop even in adolescence, particularly if insulin treatment has been inadequate. Similar complications occur later in life in type 2 patients and are frequently present at the time of diagnosis. The precise mechanisms by which diabetic microangiopathy develops are not fully understood, but a consensus is emerging pointing to a terrain of genetic influences onto which metabolic and hemodynamic derangements are superimposed. The anatomic hallmark of diabetic microangiopathy is the thickening of capillary basement membranes, which subsequently induces occlusive angiopathy, tissue hypoxia, and damage. The evolution of the numerous long-term complications of diabetes mellitus correlates well, in most cases, with the severity and duration of hyperglycemia. It is known that, for instance, postprandial glucose levels above 200 mg/dL (11 mM) are more frequently associated with renal, retinal, and neurologic complications that can commence 5 to 10 years after the debut of the disease. It is noteworthy to point out here that, at the time of initial diagnosis of type 2 diabetes, many patients have postprandial glucose levels above 200 mg/dL and already display some degree of diabetic complica Continue reading >>

Cardio-ankle Vascular Index And Indices Of Diabetic Polyneuropathy In Patients With Type 2 Diabetes

Cardio-ankle Vascular Index And Indices Of Diabetic Polyneuropathy In Patients With Type 2 Diabetes

Cardio-Ankle Vascular Index and Indices of Diabetic Polyneuropathy in Patients with Type 2 Diabetes 1Division of Endocrinology and Metabolism, Department of Internal Medicine, Jichi Medical University, Tochigi 329-0498, Japan 2Department of Laboratory Medicine, Jichi Medical University, Tochigi 329-0498, Japan 3Division of Community and Family Medicine, Centre for Community Medicine, Jichi Medical University, Tochigi 329-0498, Japan Correspondence should be addressed to Akihiko Ando ; [email protected] Received 2 November 2016; Revised 20 February 2017; Accepted 14 March 2017; Published 9 May 2017 Copyright 2017 Akihiko Ando et al. This is an open access article distributed under the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The cardio-ankle vascular index (CAVI) is used to test vascular function and is an arterial stiffness marker and potential predictor of cardiovascular events. This study aimed to analyze the relation between objective indices of diabetic polyneuropathy (DPN) and the CAVI. One hundred sixty-six patients with type 2 diabetes mellitus were included in this study. We used nerve conduction studies (NCSs) and the coefficient of variation of the R-R interval to evaluate DPN. We estimated arteriosclerosis by the CAVI. Simple and multiple linear regression analyses were performed between neuropathy indices and the CAVI. In univariate analysis, the CAVI showed significant associations with sural sensory nerve conduction velocity and median F-wave conduction velocity. Multiple linear regression analysis for the CAVI showed that sural nerve conduction velocity and median F-wave conduction velocity were significant explanatory variables sec Continue reading >>

[macroangiopathy In Diabetes Mellitus].

[macroangiopathy In Diabetes Mellitus].

(1)Schweizerisches Herz- und Gefsszentrum, Inselspital Bern, Schweiz. [email protected] In patients with diabetic angiopathy until today, no histological norhistochemical evidence has been found to define a specific type of diabeticarteriopathy. Consequently, diabetic arteriosclerosis is considered as a moreserious form of atherosclerosis characterized by its premature onset.Hyperglycemia is assumed to be the crucial pathophysiological cause of thedevelopment of macro- and microangiopathy in diabetes mellitus. Apparently,hyperglycemia has a direct toxic influence on the arterial wall by increasedaccumulation of irreversible glycosylation end products, and secondly, itprovokes endothelial dysfunction. The frequently occurring ulcerations of thediabetic foot are primarily caused by neuropathy; however, peripheral vasculardisease (PVD) is often associated. The risk of suffering from PVD in diabeticpatients is approximately four-fold. Usually, the distal segments of the lowerleg arteries are concerned, where reconstructive intervention is complicated oreven impossible. Diabetes is considered as an independent risk factor for cardio-and cerebrovascular diseases with almost twice as high rates for recurrentmyocardial infarction, and a 3.7 fold higher relative risk for stroke indiabetic, compared to non-diabetic patients. This review looks at thecorrelations between hyperglycemia and arteriosclerosis, but also the treatmentoptions in diabetic patients. Until now, there is no evidence for an association between an optimal control of blood glucose levels and a decrease in the risk of coronary heart disease, stroke, or PVD. In contrast, an attenuation ofmicrovascular lesions is achieved by stringent control of blood glucose levels.Thus, although the development of macro Continue reading >>

Pathogenesis Of Diabetic Macro- And Microangiopathy.

Pathogenesis Of Diabetic Macro- And Microangiopathy.

Pathogenesis of diabetic macro- and microangiopathy. Clinical Nephrology [01 Jul 2008, 70(1):1-9] Epidemiological investigations reveal that we must expect a rapid increase in cases of diabetes mellitus in the next few years. As a result, vascular complications in the form of macro- and microangiopathy are also expected to arise more frequently. A classical example of macroangiopathy is coronary arteriosclerosis, microangiopathy is exemplified by diabetic nephropathy. In patients suffering from diabetes, macroangiopathy manifests as atherosclerosis like in nondiabetic patients, characterized by formation of plaques that follows in stages but with an accelerated course due to the different risk factors, especially hyper- and dyslipidemia, with cumulative effects. Thus, atherosclerosis in diabetes begins earlier, is more markedly pronounced and progresses more rapidly. The pathogenetic concept is based on an endothelial lesion that occurs as a result of a diabetes-specific, endothelium-damaging parameters. In case of diabetic microangiopathy histologically characterized by a progressive glomerulosclerosis, arteriolosclerosis and interstitial fibrosis hyperglycemia, along with its consecutive and complex processes that induce matrix increase, is considered to be the primary pathogenetically relevant factor involved. Insulin resistance seems to be the major common denominator at the center of both diabetic macroangiopathy and microangiopathy. Continue reading >>

Diabetic Micro- And Macroangiopathy Treatment

Diabetic Micro- And Macroangiopathy Treatment

Diabetic micro- and macroangiopathy treatment Diabetic micro- and macroangiopathy treatment Diabetic micro- and macroangiopathy are characterized by lesions of the small and large blood vessels of the legs, heart and brain, and show severe form of diabetes of any type. Clinically, these complications, accordingly, appear in the form of diabetic foot syndrome, and occlusive vascular lesions of the lower limbs, cardiomyopathy and coronary heart disease with the development of heart attacks and heart failure, cerebrovascular disease up to the development of stroke. Diabetic foot syndrome combines pathological changes of the peripheral nervous system, blood and microvasculature, osteoarticular apparatus of the feet and directly threatens with the development of necrotizing ulcerative processes and gangrene of the foot, in severe cases leading to amputation of fingers or lower limbs. Diabetic foot syndrome occurs more frequently in diabetes mellitus type 2, about 80% of patients in 10-15 years after onset of the disease go through amputation (the main cause of disability of patients with diabetes). Amputation - serious traumatic operation which significantly limits the ability to work and social adjustment of patients with diabetes mellitus, and longevity. There are the following severity of the diabetic foot syndrome: st.0 - no ulcer, but the skin isdry and there is a deformation of the toes; st.1 - superficial ulcerative defect without evidence of infection; st.2 - deep ulcer with signs of infection without involvement of the bone tissue; st.3 - deep ulcer with involvement of bone tissue, the signs of osteomyelitis; st.4 - limited gangrene of fingers or toes; st.5 - gangrene of the entire foot. The escalating risk factors are older age, smoking, alcohol abuse, hypertensio Continue reading >>

Diabetic Macroangiopathy: Pathogenetic Insights And Novel Therapeutic Approaches With Focus On High Glucose-mediated Vascular Damage - Sciencedirect

Diabetic Macroangiopathy: Pathogenetic Insights And Novel Therapeutic Approaches With Focus On High Glucose-mediated Vascular Damage - Sciencedirect

Diabetic macroangiopathy: Pathogenetic insights and novel therapeutic approaches with focus on high glucose-mediated vascular damage Get rights and content Diabetic macroangiopathy a specific form of accelerated atherosclerosis is characterized by intra-plaque new vessel formation due to excessive/abnormal neovasculogenesis and angiogenesis, increased vascular permeability of the capillary vessels, and tissue edema, resulting in frequent atherosclerotic plaque hemorrhage and plaque rupture. Mechanisms that may explain the premature and rapidly progressive nature of atherosclerosis in diabetes are multiple, and to a large extent still unclear. However, mechanisms related to hyperglycemia certainly play an important role. These include a dysregulated vascular regeneration. In addition, oxidative and hyperosmolar stresses, as well as the activation of inflammatory pathways triggered by a dysregulated activation of membrane channel proteins aquaporins, have been recognized as key events. Here, we review recent knowledge of cellular and molecular pathways of macrovascular disease related to hyperglycemia in diabetes. We also here highlight how new insights into pathogenic mechanisms of vascular damage in diabetes may indicate new targets for prevention and treatment. Continue reading >>

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