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Updated: Mar 23, 2026
Modeling and Evaluation of Murine Diabetic Cardiomyopathy Model
Published on: November 29, 2024
Diabetes and cardiovascular disease: pathophysiology of a life-threatening epidemic
1Leeds Institute of Cardiovascular and Metabolic Medicine, The LIGHT Laboratories, University of Leeds, Clarendon Way, Leeds, UK.
Insights
Intensive glucose control may reduce cardiovascular events in some diabetes patients, particularly those with shorter disease duration and no prior cardiovascular disease (CVD). However, the impact on macrovascular complications requires further investigation.
Area of Science:
- Endocrinology
- Cardiology
- Metabolic Syndrome
Background:
- Diabetes mellitus accelerates cardiovascular disease (CVD) through risk factor clustering, including dyslipidemia, hypertension, obesity, and hyperglycemia, often linked to insulin resistance.
- Diabetic conditions promote an inflammatory and pro-thrombotic state, worsening atherothrombosis via endothelial dysfunction, oxidative stress, and altered clot formation.
- While intensive glycemic control benefits microvascular complications in diabetes, its effect on macrovascular disease remains less clear.
Purpose of the Study:
- To review the impact of hyperglycemia on atherothrombosis development.
- To examine cardiovascular outcome trials investigating intensive glucose control strategies.
Main Methods:
- Literature review of studies on diabetes, hyperglycemia, and cardiovascular outcomes.
- Analysis of randomized controlled trials assessing the effects of glycemic control on cardiovascular events.
Main Results:
- Intensive glycemic control may be safe and reduce cardiovascular events in patients with recent-onset diabetes and no pre-existing CVD.
- Mixed results exist regarding the impact of short-, medium-, and long-term glycemic control on macrovascular outcomes.
- Hyperglycemia directly influences endothelial dysfunction, oxidative stress, coagulation factors, and platelet activation, contributing to accelerated atherosclerosis.
Conclusions:
- Intensive glycemic control might offer cardiovascular benefits for specific diabetes patient populations.
- Further research is needed to clarify the long-term effects of glycemic control on macrovascular complications in diabetes.
- Understanding the interplay between hyperglycemia, insulin resistance, and atherothrombosis is crucial for managing cardiovascular risk in diabetic patients.
Abstract:
Diabetes is associated with the development of premature cardiovascular disease (CVD), which relates to the clustering of risk factors such as dyslipidaemia, hypertension, obesity and hyperglycaemia in the presence of insulin resistance. In addition, diabetes is associated with an inflammatory and pro-thrombotic environment, exacerbating the development of atherothrombosis. Insulin resistance and hyperglycaemia both contribute to the development of endothelial cell dysfunction and increased oxidative stress, culminating in accelerated atherosclerosis. Clot formation and function are also directly affected by insulin resistance and hyperglycaemia, with increased levels of coagulation factors and anti-fibrinolytic proteins and a fibrin network that is more resistant to lysis, coupled with increased platelet activation.It is well recognised that the intensification of glycaemic control leads to a reduction in microvascular complications in type 1 and type 2 diabetes; however, the same is less clear with macrovascular disease. Several randomised studies have attempted to address the effect of short-, medium- and long-term glycaemic control on cardiovascular outcomes, with mixed results. The overall interpretation of these trials suggests that intensive glycaemic control in patients with a relatively short duration of diabetes, without very poor control and with no CVD, might be safe and associated with fewer cardiovascular events.This review will summarise the effects of hyperglycaemia on the development of atherothrombosis and examine key cardiovascular outcome trials following intensive glucose control.
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