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Type 2 diabetes, characterized by insulin resistance, arises when the insulin receptors on cells lose responsiveness to insulin, diminishing the cell's capacity to take up glucose, resulting in elevated blood glucose levels. To receive a diagnosis of Type 2 diabetes, a series of blood glucose tests are necessary to assess whether the blood glucose falls within normal parameters. If the result is out of the normal range, a patient may be diagnosed as prediabetic or diabetic, depending on the...
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[Type 2 Diabetes and Vascular Endothelial Dysfunction].

Keiichi Torimoto1, Yosuke Okada1, Yoshiya Tanaka1

  • 1First Department of Internal Medicine, School of Medicine, University of Occupational and Enviromental Health, Japan.

Journal of UOEH
|March 20, 2018
PubMed
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Type 2 diabetes impairs vascular endothelial function, increasing cardiovascular risk. Medications and lifestyle changes targeting postprandial glucose control and inflammation are crucial for managing endothelial dysfunction and preventing complications.

Keywords:
diabetes medicationtype 2 diabetesvascular endothelial function

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Area of Science:

  • Cardiovascular Research
  • Endocrinology
  • Metabolic Diseases

Background:

  • Vascular endothelial function is vital for bodily homeostasis, with nitric oxide (NO) regulating blood vessel tone and preventing atherosclerosis.
  • Type 2 diabetes (T2D) significantly impairs endothelial function, leading to vascular complications and organ damage.
  • Endothelial dysfunction (ED) is an early indicator of arteriosclerotic lesions and a hallmark of T2D-associated cardiovascular disease.

Purpose of the Study:

  • To investigate the mechanisms of vascular ED in T2D.
  • To explore therapeutic strategies beyond glycemic control for protecting vascular endothelial function.
  • To emphasize the importance of managing postprandial hyperglycemia and blood glucose fluctuations in T2D patients.

Main Methods:

  • Review of existing literature on T2D, endothelial dysfunction, and cardiovascular complications.
  • Analysis of the role of hyperglycemia, hyperinsulinemia, hypoglycemia, and oxidative stress in T2D-related ED.
  • Evaluation of the vascular protective effects of specific diabetes medications.

Main Results:

  • Vascular ED in T2D is multifactorial, involving hyperglycemia, insulin resistance, hypoglycemia, and oxidative stress.
  • Postprandial metabolic abnormalities and blood glucose fluctuations exacerbate ED.
  • Certain medications, including GLP-1 receptor agonists, thiazolidinediones, biguanides, and DPP-4 inhibitors, demonstrate vascular endothelial protection.

Conclusions:

  • Managing T2D requires a holistic approach beyond HbA1c reduction, focusing on mitigating postprandial hyperglycemia, glucose variability, and hypoglycemia.
  • Selecting antiarteriosclerotic medications is crucial for preventing vascular complications in T2D.
  • Interventions aimed at correcting postprandial metabolic abnormalities are essential for preserving vascular endothelial health.