Cardiovascular disease and diabetes

Some biochemical mechanisms are discussed which may explain the increased incidence of cardiovascular disease in diabetics compared to nondiabetic humans. Absence of insulin or insensitivity of tissues to insulin leads to hyperglycaemia and elevated plasma fatty acid concentration. Hyperglycaemia can lead to modification of protein functions which can contribute to accelerated atherosclerosis. The latter is the pathological condition which underlies most cardiovascular disease. Elevated plasma fatty acid concentration impairs insulin signalling in skeletal muscle and reduce nitric oxide production in muscle. If elevated plasma fatty acid concentrations reduce endothelial nitric oxide synthase in the artery wall then this also could contribute to the increased atherosclerosis in diabetes. Also treatment of diabetes is discussed briefly in relation to cardiovascular disease.