Abstract
The vascular complications of diabetes mellitus are accountable for significant morbidity and mortality of the disease worldwide. A striking feature of diabetes is the heterogeneity in the dysregulation of angiogenesis. Excessive and disordered angiogenesis predominate in microvessels, leading to retinopathy and nephropathy. Insufficient neovascularization features heavily in the diabetic wound. This is aggravated by neuropathy and poor nutritive blood flow due to peripheral vascular disease. These complications can converge leading to amputation. Failure of neovascularization or collateralization in atheroocclusive diseased macrovessels can precipitate myocardial infarction and stroke. In this chapter, the features and mechanisms underlying the various vascular complications associated with diabetes will be reviewed.
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Abbreviations
- AGE:
-
Advanced glycation end products
- CAD:
-
Coronary artery disease
- DAG:
-
Diacylglycerol
- eNOS:
-
Endothelial nitric oxide synthase
- EPC:
-
Endothelial progenitor cell
- MAPK:
-
Mitogen activated protein kinase
- PAD:
-
Peripheral artery disease
- PKC:
-
Protein kinase C
- RAGE:
-
Receptor for advanced glycation end products
- T1DM:
-
Type 1 diabetes mellitus
- T2DM:
-
Type 2 diabetes mellitus
- VEGF:
-
Vascular endothelial growth factor
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Glossary
- Angiogenesis
-
A global term used to define the growth of new blood vessels from pre-existing ones
- Arteriogenesis
-
An adaptive process referring to the growth and widening of existing blood vessels to increase blood flow to inadequately served vascular beds
- Carbonyl stress
-
An increase in reactive carbonyl species
- Endothelial dysfunction
-
The inability of blood vessels to appropriately dilate as a result of decreased bioavailability of nitric oxide
- Hypoxia
-
Inadequate oxygen supply
- Ischemia
-
Insufficient blood supply to an organ
- Neovascularization
-
The process of new blood vessel growth in response to stress, injury or disease such as ischemia, tissue damage and cancer
- Nephropathy
-
Disease of the nephrons within the kidney
- Neuropathy
-
Diseases of the nerves
- Oxidative stress
-
A net increased in reactive oxygen species
- Retinopathy
-
Disease of the retina within the eye
- Type 1 diabetes mellitus
-
A disease characterized by high blood glucose levels due to the destruction of insulin secreting pancreatic beta cells that is responsible for ~10 % diabetes cases
- Type 2 diabetes mellitus
-
A disease characterized by high blood glucose levels, elevated insulin levels, and tissue resistance to insulin, which is responsible for ~90 % of diabetes cases
- Vascular tone
-
The ability of blood vessels to dilate and constrict
- Vasculogenesis
-
De novo production of new endothelial cells and blood vessels, a process in which EPC are involved.
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Dunn, L.L., Chan, K.H., Ng, M.K.C., Stocker, R. (2013). Vascular Complications in Diabetes. In: Dulak, J., Józkowicz, A., Łoboda, A. (eds) Angiogenesis and Vascularisation. Springer, Vienna. https://doi.org/10.1007/978-3-7091-1428-5_15
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