The pathologic continuum of diabetic vascular disease.
Hyperglycemia can promote vascular complications by multiple mechanisms, with formation of advanced glycation end products and increased oxidative stress proposed to contribute to both macrovascular and microvascular complications. Many of the earliest pathologic responses to hyperglycemia are manifest in the vascular cells that directly encounter elevated blood glucose levels. In the macrovasculature, these include endothelial cells and vascular smooth muscle cells. In the microvasculature, these include endothelial cells, pericytes (in retinopathy), and podocytes (in renal disease). Additionally, neovascularization arising from the vasa vasorum may promote atherosclerotic plaque progression and contribute to plaque rupture, thereby interconnecting macroangiopathy and microangiopathy.
Orasanu
Gabriela
G
Cardiovascular Division, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02115, USA.
Plutzky
Jorge
J
D002318:Cardiovascular Diseases / Q000097:blood / Q000209:etiology* / Q000473:pathology*; D048909:Diabetes Complications / Q000097:blood / Q000209:etiology* / Q000473:pathology*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications* / Q000473:pathology; D004730:Endothelium, Vascular / Q000473:pathology; D017127:Glycation End Products, Advanced / Q000097:blood; D006801:Humans; D007249:Inflammation / Q000150:complications / Q000473:pathology; D055806:Microvessels / Q000473:pathology; D009389:Neovascularization, Pathologic / Q000150:complications*; D018384:Oxidative Stress; D020286:Pericytes / Q000473:pathology; D050199:Podocytes / Q000473:pathology; D017382:Reactive Oxygen Species
D017127:Glycation End Products, Advanced; D017382:Reactive Oxygen Species