The Pathophysiology and Metabolic Impact of Hyperglycemia

  • Ronald A. Codario
Chapter
Part of the Current Clinical Practice book series (CCP)

Abstract

Accelerated vascular injury and inflammation are intimately associated with the devastating complications of type-2 diabetes. This process is initiated and perpetuated by the pathophysiological consequences of the hyperglycemic state. The vascular devastation of hyperglycemia can occur by several mechanisms, impacting the vessel wall, monocyte derived macrophages, and vascular smooth muscle cells.s

Key Words

Hyperglycemia Vascular injury Inflammation Hyperglycemia Monocyte derived macrophages Vascular smooth muscle cells 

References

  1. 1.
    Davi G, Ciabattoni G, Consoli A, Mazzetti A, Falco A. In vivo formation of prostaglandin F2 and platelet activation in diabetes mellitus. Circulation 1999;99:224–229.PubMedCrossRefGoogle Scholar
  2. 2.
    UK Prospective Diabetes Study. Overview of six years of therapy of type 2 diabetes. Diabetes 1995;44: 1249–1258.CrossRefGoogle Scholar
  3. 3.
    Brownlee M. The pathobiology of diabetic complications: a unifying mechanism. Diabetes 2005;54: 1615–1625.PubMedCrossRefGoogle Scholar
  4. 4.
    The Diabetes Control and Complications Trial Research group. The effect of intensive treatment of diabetes on the development and progression of long term complications in insulin dependent diabetes mellitus. N Engl J Med 1993;329:977–986.CrossRefGoogle Scholar
  5. 5.
    Fonseca V, Rosenstock J, et al. Effect of metformin and rosiglitazone combination therapy in patients with type 2 diabetes. JAMA 2000;283:1695–1702.PubMedCrossRefGoogle Scholar
  6. 6.
    Hanefeld M, Fischer S, Julius U. Risk factors for myocardial infarction and death in newly detected NIDDM: the diabetes Intervention Study, 11 year follow up. Diabetologia 1996;39:1577–1583.PubMedCrossRefGoogle Scholar
  7. 7.
    O’Keefe JH, Miles JM, et al. Improving the adverse cardiovascular prognosis of type 2 diabetes. Mayo Clin Proc. 1999;74:171–180.PubMedCrossRefGoogle Scholar
  8. 8.
    The European diabetes Epidemiology group (DECODE). Glucose tolerance and cardiovascular mortality: comparison of fasting and 2-hour diagnostic criteria. Arch Intern Med 2001;161:397–405.CrossRefGoogle Scholar
  9. 9.
    Nathan DM, Meigs J, et al. The epidemiology of cardiovascular disease in type 2 diabetes mellitus. Lancet 1997;350(Suppl 1):S14–S19.Google Scholar
  10. 10.
    Panaram G. Mortaliaty and survival in type 2 diabetes mellitus. Diabetologia 1987;30:123–131.CrossRefGoogle Scholar
  11. 11.
    Renders CM, Valk GD, Franse LV, et al. Long term effectiveness of a quality improvement program for patients with type 2 diabetes in general practice. Diabetes Care 2001;24:1365–1370.PubMedCrossRefGoogle Scholar
  12. 12.
    Donahue RP, Abbott RD, Reed DM, Yano K. Postchallenge glucose concentration and coronary heart disease in men of Japanese ancestry. Honlulu Heart Program. Diabetes 1987;36(2):689–692.PubMedCrossRefGoogle Scholar
  13. 13.
    Kannel WB, McGee DL. Diabetes and cardiovascular disease: the Framingham Study. JAMA 1979;241:2035–2038.PubMedCrossRefGoogle Scholar
  14. 14.
    Geiss LS, Herman WH, Smith PJ. The Pacific and Indian Ocean trial. Diabetes Care 1993;16:434–442.CrossRefGoogle Scholar
  15. 15.
    Tominaga M, Eguchi H, Manaka H, IgarashiK, Kato T, Sekikawa A. Impaired glucose tolerance is a risk factor for cardiovascular disease, but not impaired fasting glucose. The funagata diabetes Study. Diabetes Care 1999;22:920–924.PubMedCrossRefGoogle Scholar
  16. 16.
    Balkau B, Shipley M, Jarrett RJ. High blood glucose concentration is a risk factor for mortality in middle aged nondiabetic men. The Whitehall study. Diabetes Care 1998;21:360–367.PubMedCrossRefGoogle Scholar
  17. 17.
    Barrett-Connor E, Ferrara A. Isolated postchallenge hyperglycemia and the risk of fatal cardiovascular disease in older women and men. The Rancho Bernardo Study. Diabetes Care 1998;21:1236–1239.PubMedCrossRefGoogle Scholar
  18. 18.
    Turner RC, et al. Glycemic control with diet, sulfonylurea, metformin or insulin in patients with type 2 diabetes. JAMA 1999;281:2005–2012.PubMedCrossRefGoogle Scholar
  19. 19.
    de Veciana M, Major C, Morgan M, Asrat T, Toohey J, Lien J. Postprandial versus preprandial glucose monitoring in women with gestation diabetes mellitus requiring insulin. N Engl J Med 1995;333(9): 1237–1241.PubMedCrossRefGoogle Scholar
  20. 20.
    Holmboe ES. Oral antihyperglycemic therapy for type 2 diabetes: clinical applications. JAMA 2002;287:373–376.PubMedCrossRefGoogle Scholar
  21. 21.
    Donahue RP, Abbott RD, Reed DM, Yano K. Postchallenge glucose concentration and coronary heart disease in men of Japanese ancestry. Honolulu Heart Program. Diabetes 1987;36:689–692.PubMedCrossRefGoogle Scholar
  22. 22.
    Nathan DM, Buse MB, Davidson JB. Medical management of hyperglycaemia in type-2 diabetes; a consensus algorithm. Diabetologia 2009;52(1):17–30.PubMedCrossRefGoogle Scholar
  23. 23.
    Ohkubo Y, Kishikawa H. Intensive insulin therapy prevents the progression of diabetic microvascular complications in Japanese patients with noninsulin dependent diabetes mellitus. Diabetes Res Clin Pract 1995;28:103–117.PubMedCrossRefGoogle Scholar
  24. 24.
    Monnier L. Contributions of postprandial glucose and fasting plasma glucose to A1C. Diabetes Care 2003;26:881–885.PubMedCrossRefGoogle Scholar

SupplementAry Readings

  1. Bailey CJ. Biguanides and NIDDM. Diabetes Care 1992;15:755–772.PubMedCrossRefGoogle Scholar
  2. Cefalu WT, et al. Inhaled human insulin treatment in type 2 diabetes. Ann Intern Med 2001;134: 203–207.PubMedCrossRefGoogle Scholar
  3. Chiasson JL, Josse RG, Hunt JA. The efficacy of acarbose in the treatment of patients with non insulin dependent diabetes mellitus. The STOP_NIDDM trial. Ann Intern Med 1994;121:928–935.PubMedCrossRefGoogle Scholar
  4. Chiasson JL, Josse RG, et al. Acarbose for prevention of type 2 diabetes mellitus. The STOP-NIDDM randomized trial. Lancet 2002;359:2072–2077.PubMedCrossRefGoogle Scholar
  5. DeFronzo R, et al. Efficacy of metformin in patients with NIDDM. N Engl J Med 1995;333:541–549.PubMedCrossRefGoogle Scholar
  6. Effect of intensive blood-glucose control with metformin on complications in overweight patients with type 2 diabetes. Lancet 1998;352:854–862.Google Scholar
  7. Groop L. Sulfonyureas in NIDDM. Diabetes Care 1992;15:737–754.PubMedCrossRefGoogle Scholar
  8. Harrigan RA, et al. Oral Agents for the treatment of type 2 diabetes mellitus: pharmacology, toxicity and treatment. Ann Emerg Med 2001;38(1):68.PubMedCrossRefGoogle Scholar
  9. Horton ES, Clinkingbead C, et al. Nateglinide alone and in combination with metformin improves glycemic control by reducing mealtime glucose levels in type 2 diabetes. Diabetes Care 2000;23:1660–1665.PubMedCrossRefGoogle Scholar
  10. Inzucchi SF, Maggs DG, et al. Efficacy and metabolic effects of metformin and troglitazone in type II diabetes mellitus. N Engl J Med 1998;338:867–872.PubMedCrossRefGoogle Scholar
  11. Lenhard MJ, Reeves GD. Continuous subcutaneous insulin infusions: a comprehensive review of insulin pump therapy. Arch Intern Med 2001;161(19):2293.PubMedCrossRefGoogle Scholar
  12. Loh KC, Leow MK. Current therapeutic strategies for type 2 diabetes mellitus. Ann Acad Med Singapore 2003;31:722–729.Google Scholar
  13. Nathan DM. Roussell A, et al. Glyburide or insulin for metabolic control in noninsulin dependent mellitus: a randomized, double blind study. Ann Intern Med 1988;108:334–340.PubMedCrossRefGoogle Scholar
  14. Saudek CD, et al, Implantable insulin pump vs. multiple dose insulin for noninsulin dependent diabetes mellitus; a randomized clinical trial. JAMA 1996;276:1322–1327.PubMedCrossRefGoogle Scholar
  15. Sinha R, et al. Prevalence of impaired glucose intolerance among children and adolescents with marked obesity. N Engl J Med 2002;346:802–810.PubMedCrossRefGoogle Scholar
  16. Stratton IM, Adler AI, et al. Association of glycemia with macrovascular and microvascular complications of type 2 diabetes: prospective observational study. BMJ 2000;321:405–412.PubMedCrossRefGoogle Scholar
  17. Turner RC. Glycemic control with diet, sulfonylurea, metformin, or insulin in patients with type 2 diabetes: progressive requirement for multiple therapies. JAMA 1999;281:2005–2012.PubMedCrossRefGoogle Scholar
  18. UKPDS. Effect of intensive blood glucose control with metformin on complications in overweight patients with type 2 diabetes. Lancet 1998;352(9131):854–865.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  • Ronald A. Codario
    • 1
  1. 1.University of Pennsylvania Health System Thomas Jefferson University HospitalPhiladelphiaUSA

Personalised recommendations