Type 2 Diabetes and Vascular Complications: Current Perspectives on Pathophysiology and Management Strategies

Area of Science:

• Endocrinology and Metabolism
• Cardiovascular Research
• Diabetology

Background:

• Type 2 diabetes mellitus (T2DM) affects over 537 million adults globally, with India contributing significantly to the disease burden.
• Hyperglycemia-induced oxidative stress is a key factor in T2DM pathogenesis, disrupting the balance of reactive oxygen species (ROS) and leading to vascular damage.
• This oxidative stress activates pathological pathways, promoting inflammation and the development of diabetic complications.

Purpose of the Study:

• To systematically review literature on the pathogenesis and therapeutic management of diabetic microvascular and macrovascular complications.
• To synthesize current knowledge on the impact of oxidative stress in T2DM and its role in disease progression.

Main Methods:

• Systematic literature review of peer-reviewed articles published between 2010 and 2024.
• Searches conducted in major scientific databases including PubMed, Web of Science, Scopus, ScienceDirect, and Google Scholar.
• Keywords focused on diabetic complications, pathogenesis, and treatment strategies.

Main Results:

• Microvascular complications include nephropathy, retinopathy, neuropathy, and sexual dysfunction.
• Macrovascular complications increase the risk of cardiovascular diseases such as coronary artery disease, peripheral arterial disease, stroke, and heart failure.
• Oxidative stress, AGEs formation, PKC activity, and inflammation are critical in the development of these vascular issues.

Conclusions:

• Effective management requires strict glycaemic control, lifestyle changes, and pharmacological interventions.
• Key therapies include RAAS blockers, SGLT2 inhibitors, PDE5 inhibitors, GLP-1 receptor agonists, and anti-VEGF agents.
• Early diagnosis, risk factor management, and tailored treatments are essential for improving patient outcomes and slowing disease progression.