Peripheral vascular disease and type 2 diabetes mellitus.
Patients with Type 2 diabetes mellitus frequently have peripheral vascular disease, with a predilection for the lower legs. In this review potential mechanisms for this high prevalence and altered distribution are explored. It is hypothesised that the metabolic abnormalities in the prediabetic phase predispose to a more distal and aggressive atherosclerosis. Once diabetes has developed this process is accelerated due to chronic hyperglycaemia. Furthermore, endothelial damage, non-enzymatic glycosylation and polyneuropathy could lead to impaired vascular remodelling and collateral formation.
Schaper
N C
NC
Division of Endocrinology, Department of Internal Medicine, Academic Hospital Maastricht and Cardiovascular Institute Maastricht (CARIM), The Netherlands. nsc@sint.azm.nl
Nabuurs-Franssen
M H
MH
Huijberts
M S
MS
D003924:Diabetes Mellitus, Type 2 / Q000503:physiopathology*; D003925:Diabetic Angiopathies / Q000503:physiopathology*; D003929:Diabetic Neuropathies / Q000503:physiopathology; D006801:Humans; D006943:Hyperglycemia / Q000503:physiopathology; D007249:Inflammation / Q000503:physiopathology; D007333:Insulin Resistance; D016491:Peripheral Vascular Diseases / Q000503:physiopathology*