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Vascular Complications in Diabetes

  • Louise L. DunnEmail author
  • Kim Hoe Chan
  • Martin K. C. Ng
  • Roland Stocker
Chapter

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.

Keywords

Diabetes mellitus Angiogenesis Neovascularization Diabetic vasculopathies 

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

Notes

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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Copyright information

© Springer-Verlag Wien 2013

Authors and Affiliations

  • Louise L. Dunn
    • 1
    • 2
    Email author
  • Kim Hoe Chan
    • 3
  • Martin K. C. Ng
    • 3
  • Roland Stocker
    • 1
    • 2
  1. 1.Victor Chang Cardiac Research InstituteDarlinghurstAustralia
  2. 2.Faculty of MedicineThe University of New South WalesKensingtonAustralia
  3. 3.Department of CardiologyRoyal Prince Alfred HospitalCamperdownAustralia

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