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Microangiopathy in diabetes mellitus: I. Causes, prevention and treatment
1Department of Surgery, University College and Middlesex School of Medicine, Middlesex Hospital, London, UK.
Abstract:
Microangiopathy is the major cause of death in Insulin Dependent Diabetes Mellitus. However, the pathogenesis of microangiopathy is still far from clear. This paper is a review of the literature on diabetic microangiopathy and discusses the current theories concerning its causes, prevention and treatment. The roles of abnormal glucose metabolism, protein glycosylation, genetic factors and puberty as well as the changes in vascular endothelium, capillary permeability and blood constituents, in the development of microangiopathy are discussed. The benefits of strict control of blood glucose concentrations are discussed along with the action of various pharmaceutical preparations such as aldose reductase inhibitors, hydroxyrutosides, pentoxifylline and free radical scavengers currently assessed in the prevention or treatment of diabetic microangiopathy.
Insights
Diabetic microangiopathy, a major cause of death in Insulin Dependent Diabetes Mellitus, involves complex factors like glucose metabolism and vascular changes. Strict blood glucose control and specific medications show promise for prevention and treatment.
Area of Science:
- Endocrinology
- Vascular Biology
- Metabolic Diseases
Background:
- Diabetic microangiopathy is a leading cause of mortality in Insulin Dependent Diabetes Mellitus.
- The precise pathogenesis of diabetic microangiopathy remains incompletely understood.
- This review synthesizes current knowledge on the condition.
Purpose of the Study:
- To review existing literature on diabetic microangiopathy.
- To discuss current theories regarding its etiology, prevention, and treatment.
- To explore the roles of various contributing factors and therapeutic interventions.
Main Methods:
- Literature review of studies on diabetic microangiopathy.
- Discussion of proposed pathogenic mechanisms.
- Analysis of preventative and therapeutic strategies.
Main Results:
- Abnormal glucose metabolism, protein glycosylation, genetic factors, and puberty contribute to microangiopathy.
- Changes in vascular endothelium, capillary permeability, and blood constituents are implicated.
- Strict glycemic control is beneficial.
Conclusions:
- Understanding the multifactorial pathogenesis is crucial for effective management.
- Pharmacological agents like aldose reductase inhibitors and free radical scavengers are under investigation.
- Further research is needed to clarify optimal prevention and treatment strategies.