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Vascular complications of diabetes mellitus
1Department of Diabetes and Microcirculation, Beijing Tongren Hospital, Peoples Republic of China. bjtfb@public.east.cn.net
Abstract:
1. Macro- and microvascular diseases are the main chronic complications of diabetes mellitus (DM). 2. It has been shown that DM patients have more severe nailfold microcirculatory disturbances than patients with liver cirrhosis or systemic lupus erythematosus (SLE). 3. It has been shown that the glomerular basement membrane of diabetic rats is significantly thickened compared with that of normal rats (295.5 +/- 45.1 vs 184.8 +/- 33.2 nm). 4. Gastric mucosal blood flow (GMBF) in 41 patients with non-insulin-dependent diabetes mellitus (NIDDM) was determined with a laser Doppler flowmeter. The results showed that average GMBF values at 14 sites in the gastric mucosa were significantly lower in NIDDM patients than in control subjects. 5. The percentage of painless acute myocardial infarction (AMI) among 50 patients with DM was 22.0% and the mortality of AMI was 22.0% (11 cases). Both these values were higher than the corresponding values in patients without DM (9.9 and 11.4%, respectively; P < 0.05). 6. Cerebrovascular disease is more prevalent in diabetic patients than in non-diabetics and the mortality of stroke in DM patients is two-fold higher than that of non-diabetic patients. 7. Diabetes can result in widespread macrovascular atherosclerosis and microcirculatory disorders of multiple organs.
Insights
Diabetes mellitus (DM) causes severe vascular complications, including microcirculatory disturbances and macrovascular diseases affecting organs like the heart and brain. These complications increase the risk and mortality of conditions such as acute myocardial infarction and stroke.
Area of Science:
- Cardiology
- Endocrinology
- Nephrology
- Gastroenterology
Background:
- Diabetes mellitus (DM) is a leading cause of chronic macro- and microvascular diseases.
- Diabetic patients exhibit more pronounced nailfold microcirculatory disturbances compared to those with liver cirrhosis or systemic lupus erythematosus.
- Diabetic nephropathy is characterized by significant thickening of the glomerular basement membrane.
Purpose of the Study:
- To investigate the impact of diabetes mellitus on macro- and microvascular complications.
- To assess microcirculatory disturbances in diabetic patients.
- To evaluate the prevalence and mortality of cardiovascular and cerebrovascular events in individuals with diabetes.
Main Methods:
- Comparative analysis of nailfold microcirculation in DM patients versus control groups.
- Histopathological examination of glomerular basement membrane thickness in diabetic rats.
- Laser Doppler flowmetry to measure gastric mucosal blood flow (GMBF) in non-insulin-dependent diabetes mellitus (NIDDM) patients.
- Retrospective analysis of acute myocardial infarction (AMI) and stroke incidence and mortality in diabetic and non-diabetic populations.
Main Results:
- Diabetic rats showed significantly thickened glomerular basement membranes.
- NIDDM patients exhibited significantly lower GMBF compared to control subjects.
- The incidence and mortality of painless AMI were higher in diabetic patients.
- Cerebrovascular disease and stroke mortality were notably higher in diabetic individuals.
Conclusions:
- Diabetes mellitus is associated with widespread macrovascular atherosclerosis and microcirculatory dysfunction across multiple organs.
- These vascular complications significantly increase the risk and mortality of cardiovascular and cerebrovascular events in diabetic patients.
- Early detection and management of vascular complications are crucial for improving outcomes in diabetes mellitus.