[Management of diabetic vasculopathy]
1Service d'Endocrinologie et de Diabétologie, Clinique Marc Linquette CHRU, Lille, France.
Insights
Diabetic patients face high mortality from atherothrombotic cardiovascular disease. Early screening and prevention strategies for diabetic vascular risk are crucial to reduce thrombotic events.
Area of Science:
- Cardiovascular Medicine
- Endocrinology
- Pathophysiology
Context:
- Diabetic patients exhibit a high mortality rate primarily due to atherothrombotic cardiovascular disease.
- Key contributing factors include hyperinsulinemia, insulin resistance, dyslipidemia, chronic hyperglycemia, impaired endothelial and immune cell function, and hypercoagulability.
Purpose:
- To elucidate the multifaceted pathogenesis of atherothrombotic disease in diabetes.
- To outline the clinical manifestations and common characteristics of this condition.
- To emphasize the importance of therapeutic strategies focused on screening and prevention.
Summary:
- Diabetic atherothrombotic disease manifests clinically as coronary, peripheral, and cerebral vascular insufficiency, alongside reno-vascular hypertension.
- Hallmarks include a prolonged latent period, frequent acute complications, and widespread distal vascular issues.
- The pathogenesis involves metabolic dysregulation and pro-thrombotic states.
Impact:
- Improved understanding of diabetic atherothrombotic disease pathogenesis.
- Highlights the need for codified therapeutic strategies including screening and prevention.
- Evaluating diabetic vascular risk can significantly decrease thrombotic event prevalence.
Abstract:
The high prevalence rate of mortality in diabetic patients is explained by atherothrombotic cardiovascular disease. Hyperinsulinemia and insulin resistance, dyslipidemia, chronic hyperglycemia, decrease of endothelial cells and of monocytes-macrophage cell functions, and hypercoagulability are the main side-effects which are involved in the pathogenesis of diabetic atherothrombotic disease. Its clinical manifestations are coronary heart disease, peripheral vascular insufficiency, cerebral vascular insufficiency and reno-vascular hypertension. The common characteristics are a clinical latent period, the frequency of acute complications and the widespread bilateral distal localisation of vascular insufficiency. The therapeutic strategy in diabetic atherothrombotic disease is becoming better codified, leading to screening and prevention. The evaluation of diabetic vascular risk could reduce the prevalence of thrombotic events.
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