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Effects of Diabetes and Insulin Resistance on Endothelial Functions

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Diabetes and Cardiovascular Disease

Part of the book series: Contemporary Cardiology ((CONCARD))

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Abstract

Cardiovascular (CV) complications are the primary cause of mortality and morbidity in patients with Type 1 (T1D) and Type 2 diabetes (T2D), which affect a variety of tissues and organs including the retina, myocardium, nerves, skin, and kidney. Insulin resistance and hyperglycemia are responsible for many abnormalities of vascular endothelial function in diabetes. These effects may be mediated via alterations in signal transduction pathways induced by advanced glycation end-products (AGE), reactive oxidative stress, and others. These, in turn, lead to selective impairment or enhancement of insulin signaling and affect both pro- and anti-atherogenic actions of insulin. Hyperinsulinemia, when present concomitantly with insulin resistance, may enhance insulin’s pro-atherogenic actions. Agents that can target the abnormalities of hyperglycemia-induced vascular dysfunction and improve insulin resistance in the endothelium can ultimately prevent the microvascular and CV complications of diabetes.

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Acknowledgements

The authors acknowledge the contributions of several colleagues and collaborators that shaped the views expressed in this chapter; grants from the NIH (R01 EY016150, R01 DK071359, R01-DK-053105, 5P30-DK-036836), DERC (5 P30 DK36836-23), NIDDK (1DP3-DK-094333-01), ADA (1-08-RA-93), Joslin NIH Training Grant (5 T32 DK007260-33), Beatson Foundation Gift, and the Dianne Nunnally Hoppes Fund. J.F. is supported by Mary K. Iacocca Research Fellowship Award. M.G.Y. is supported by the American Diabetes Association (ADA; 9-18-CVD1-005). Q.L. was supported by the American Diabetes Association Mentor-Based Postdoctoral Fellowship Award.

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  1. Dianne Nunnally Hoppes Laboratory for Diabetes Complications, Section of Vascular Cell Biology, Joslin Diabetes Center, Harvard Medical School, Boston, MA, USA

    Jialin Fu, Marc Gregory Yu, Qian Li, Kyoungmin Park & George L. King

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  1. Steward St. Elizabeth’s Medical Center, Tufts University Medical School, Brighton, MA, USA

    Michael Johnstone

  2. Beth Israel Deaconess Medical Center / Harvard Medical School, Boston, MA, USA

    Aristidis Veves

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Fu, J., Yu, M.G., Li, Q., Park, K., King, G.L. (2023). Effects of Diabetes and Insulin Resistance on Endothelial Functions. In: Johnstone, M., Veves, A. (eds) Diabetes and Cardiovascular Disease. Contemporary Cardiology. Humana, Cham. https://doi.org/10.1007/978-3-031-13177-6_3

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