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Microangiopathy in diabetes mellitus: II. Features, complications and investigation
1Department of Surgery, University College and Middlesex School of Medicine, London, UK.
Abstract:
This paper reviews the current literature on the morphological, physiological, pathological and rheological features of microangiopathy in diabetes mellitus. The current theories explaining the development of these features as well as complications resulting from them are discussed. In the first section the morphological changes including capillary basement membrane thickening as well as physiological changes such as increased permeability and reduced diffusion of oxygen across capillary endothelium are discussed. Rheological factors and functional changes in blood flow as well as capillary proliferation and degeneration are addressed. The second section of this paper deals with the complications suffered by diabetics such as retinopathy, nephropathy, neuropathy, cardiovascular disease and skin ulceration. The role of microangiopathy in the pathogenesis of these complications is reviewed. The last section discusses the investigative techniques available to the clinician and researcher in the study of micro-angiopathy. These include various methods of blood flow measurement such as plethysmography, LASER Doppler flowmetry, capillary microscopy and clearance of tracers from the skin microcirculation.
Insights
Diabetic microangiopathy involves changes in blood vessels, leading to complications like retinopathy and nephropathy. This review covers its features, causes, and diagnostic methods for better understanding and management.
Area of Science:
- Vascular Biology
- Diabetology
- Pathophysiology
Background:
- Diabetes mellitus is associated with microangiopathy, a complex condition affecting small blood vessels.
- Microangiopathy manifests with morphological, physiological, pathological, and rheological changes.
- Understanding these changes is crucial for managing diabetic complications.
Purpose of the Study:
- To review the current literature on microangiopathy in diabetes mellitus.
- To discuss the pathogenesis and complications of diabetic microangiopathy.
- To outline investigative techniques for studying microangiopathy.
Main Methods:
- Literature review of morphological, physiological, pathological, and rheological features.
- Discussion of theories on the development of microangiopathy and its complications.
- Overview of investigative techniques including blood flow measurement methods.
Main Results:
- Morphological changes include capillary basement membrane thickening.
- Physiological changes involve increased permeability and reduced oxygen diffusion.
- Pathological and rheological factors, including blood flow alterations and capillary changes, are discussed.
- Microangiopathy is implicated in diabetic complications such as retinopathy, nephropathy, neuropathy, cardiovascular disease, and skin ulceration.
Conclusions:
- Diabetic microangiopathy is a multifactorial condition with significant clinical implications.
- The review highlights the link between microvascular changes and major diabetic complications.
- Available investigative techniques aid in the clinical and research study of microangiopathy.