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Prevention of Microvascular Complications of Diabetes: General Overview

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Principles of Diabetes Mellitus

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Abstract

Chronic hyperglycemia in patients with diabetes produces characteristic pathologic findings in the nerve, retina, and kidneys. These findings, which result from elevated intravascular glucose flooding overburdened and defective metabolic pathways, cause effects at the molecular, macromolecular, cellular, and tissue levels. Characteristic findings at basement membranes and vascular cells appear to be due to, at least in part, protein kinase C activation, altered activity of transcription factors and growth factors, and overall increased reactive oxygen species formation and inflammation. Glucose also promotes cross-linking of proteins and nucleic acids to alter cellular structure and function via advanced glycosylated end products. The prevention of complications is the main rationale for treating hyperglycemia, and strategies that result in lowered HbA1c values have been shown to reduce complications. Research that deciphers the manner in which hyperglycemia leads to these complications provides potential additional targets for preventing or ameliorating complications, apart from the standard strategy of lowering HbA1c.

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Authors and Affiliations

  1. Endocrinology and Metabolism, Mt. Sinai Beth Israel Hospital, New York, NY, USA

    Vincent Yen

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  1. Vincent Yen
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Correspondence to Vincent Yen .

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  1. Lenox Hill Hospital Division of Endocrinology, New York, New York, USA

    Leonid Poretsky

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Yen, V. (2016). Prevention of Microvascular Complications of Diabetes: General Overview. In: Poretsky, L. (eds) Principles of Diabetes Mellitus. Springer, Cham. https://doi.org/10.1007/978-3-319-20797-1_45-1

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  • DOI: https://doi.org/10.1007/978-3-319-20797-1_45-1

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