Skip to main content
SpringerLink
Log in
Book cover

Hyperglycemia, Diabetes, and Vascular Disease pp 3–20Cite as

Hyperglycemia, Diabetes, and Vascular Disease: An Overview

  • Chapter

Part of the book series: Clinical Physiology Series ((CLINPHY))

Abstract

Diabetes is a disease, or group of diseases, characterized by hyperglycemia, a relative or absolute lack of insulin, and a propensity to vascular disease and neuropathy. Two types of vascular disease have been described: a microangiopathy that affects capillaries and arterioles in the eye and kidney and other organs and is relatively unique to diabetes, and a macroangiopathy that is morphologically very similar to atherosclerosis in nondiabetics, but is more extensive and occurs at an earlier age (72). In addition, alterations in vascular reactivity have been observed that could hypothetically play a role in the pathogenesis of vasospastic angina (Chapter 4), hypertension (81) and an impaired response of diabetics to ischemia. Patients with primary diabetes are classified as insulin-dependent (type I) or non-insulin-dependent (type II), based on differences in etiology and clinical characteristics. Micro- and macro-vascular disease are more common among patients with both subtypes of diabetes than in the general population (Table 1.1).

This is a preview of subscription content, log in via an institution.

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   119.00
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. American Diabetes Association: Role of cardiovascular risk factors in prevention and treatment of macrovascular disease in diabetes. Diabetes Care 12: 573–579, 1989, Consensus S.

    Google Scholar 

  2. Anderson, S., and Brenner, B.: Pathogenesis of diabetic nephropathy: hemodynamic considerations. DiabeteslMetab. Rev. 4: 163–177, 1988.

    Article  CAS  Google Scholar 

  3. Beyermears, A., Cruz, E., Edelist, T., and Varaglannis, F.: Diminished proteinuria in diabetes mellitus by sorbinil, an aldose reductase inhibitor. Pharmacology 32: 52–60, 1986.

    Article  CAS  Google Scholar 

  4. Bilous, R. W., Steffes, M. W., Goetz, F. C., Sutherland, D. M., and Mauer S. M.: Pancreas transplantation for more than two years ameliorates glomerular pathology in insulin-dependent diabetic patients. N. Engl. J. Med. 321: 8580–8585, 1989.

    Article  Google Scholar 

  5. Brownlee, M., Cerami, A., and Vlassara, H.: Advanced glycosylation end products in tissue and the biochemical basis of diabetic complications. N. Engl. J. Med. 318: 1315–1321, 1988.

    Article  PubMed  CAS  Google Scholar 

  6. Brownlee, M., Cerami, A., and Vlassara, H.: Advanced products of nonenzymatic glycosylation and the pathogenesis of diabetic vascular disease. Diabetes/Metab. Rev. 4: 437–451.

    Google Scholar 

  7. Bucala, R., Tracey, K. J., and Cerami, A.: Advanced glycosylation products quench nitric oxide and mediate defective endothelium-dependent vasodilatation in experimental diabetes. J. Clin. Invest. 87: 432–438, 1991.

    Article  PubMed  CAS  Google Scholar 

  8. Cerami, A., Vlassara, H., and Brownlee, M.: Role of advanced glycosylation products in complications of diabetes. Diabetes Care 11 (Suppl. 1): 3–79, 1988.

    Google Scholar 

  9. Chobanian, A. V., Arguilla, E. R., Clarkson, T. B., Eder, H. A., Howard, C. F., Regan, T. J., and Williamson, J. R.: Proceedings on a task force on animals appropriate for studying diabetes mellitus and its complications. Diabetes 31 (Suppl 1): 54–64, 1982.

    PubMed  CAS  Google Scholar 

  10. Christiansen, J. S., Gammelgaard, J., Tronier, B., Svendsen, P. A., and Parving, H. H.: Kidney function and size in diabetes before and during initial insulin treatment. Kidney Int. 21: 683–688, 1982.

    Article  PubMed  CAS  Google Scholar 

  11. Craven, P. A., and Derubertis, F. R.: Sorbinil suppresses glomerular prostaglandin production in the streptozotocin diabetic rat. Metabolism 38: 649–654, 1989.

    Article  PubMed  CAS  Google Scholar 

  12. Craven, P. A., ‘Davidson, C. M., and Derubertis, F. R.: Increase in deacylglycerol mass in isolated glomeruli by glucose from de novo synthesis of glycerolipids. Diabetes 39: 667–674, 1990.

    Article  PubMed  CAS  Google Scholar 

  13. Cohen, M. D.: Aldose reductase glomerular metabolism and diabetic nephropathy Metabolism 35 (Suppl 1): 55–59, 1986.

    Article  PubMed  CAS  Google Scholar 

  14. Davis, M. D.: Diabetic retinopathy: a clinical overview. Diabetes/Metab. Reu. 4: 291–321, 1988.

    Article  CAS  Google Scholar 

  15. Dcct Research Group: Diabetes Control and Complications Trial (Dcct): update Diabetes Care 13: 427–433, 1990.

    Article  Google Scholar 

  16. Dcct Research Group: Diabetes Control and Complications Trial (Dcct): results of feasibility study. Diabetes Care 10: 1–19, 1987.

    Article  Google Scholar 

  17. Donahue, R. R., Abbott, R. D., Reed, D. M., and Yano, K.: Postchallenge glucose concentration and coronary heart disease in men of Japanese ancestry. Honolulu Heart Program. Diabetes 36: 689–692, 1985.

    Article  Google Scholar 

  18. Drury, P. L.: Diabetes and arterial hypertension. Diabetologia 24: 1–9, 1983.

    Article  PubMed  CAS  Google Scholar 

  19. Engerman, R. L., and Kern, T. S.: Progression of diabetic retinopathy during good glycemic control. Diabetes 36: 808–812, 1987.

    Article  PubMed  CAS  Google Scholar 

  20. Engerman, R. L., and Kern, T. S.: Hyperglycemia and the development of glomerular pathology: diabetes compared with galactosemia. Kidney Int. 36: 41–45, 1988.

    Article  Google Scholar 

  21. Engerman, R. L., Bloodworth, J. M. B., and Nelson, S.: Relationship of microvascular disease to metabolic control. Diabetes 26: 760–769, 1977.

    Article  PubMed  CAS  Google Scholar 

  22. Engerman, R. L., and Kern, T. S.: Experimental galactosemia produces diabetic-like retinopathy. Diabetes 33: 97–100, 1984.

    Article  PubMed  CAS  Google Scholar 

  23. Feingold, K. R., Lee, T. H., Chung, M. U., and Siperstein, M. D.: Muscle capillary basement membrane width in patients with vacor-induced diabetes. J. Clin. Invest. 78: 102–107, 1986.

    Article  PubMed  CAS  Google Scholar 

  24. Friedman, E.: Diabetic renal disease. In: Ellenberg and Rifkins Diabetes Mellitus, Theory and Practice, 4 Ed., edited by H. Rifkin and D. Porte. New York: Elsevier, 1990, pp. 684–709.

    Google Scholar 

  25. Goldfarb, S., Simmons, D. A., and Kern, E. F. O.: Amelioration of glomerular hyperfiltration in acute experimental diabetes mellitus by dietary myo-inositol supplementation and aldose reductase inhibition. Trans. Assoc. Am. Physicians 99: 67–72, 1986.

    PubMed  CAS  Google Scholar 

  26. Gonzalez, A.-M., Sochor, M., Hotersall, J. S., and Mclean, P.: Effect of aldose reductase inhibitor (sorbinil) on integration of polyol pathway, pentose phosphate pathway and glycolytic route in diabetic lens. Diabetes 35: 1200–1205, 1986.

    Article  PubMed  CAS  Google Scholar 

  27. Greene, D. A., Lattimer, S. A., and Siman, A. A. F.: Sorbitol, phosphoinositides and sodium-potassium-Atpase in the pathogenesis of diabetic complications. N. Engl. J. Med. 316: 599–606, 1987.

    Article  PubMed  CAS  Google Scholar 

  28. Gryglewski, R., Rotting, R. M., and Vane, J. R.: Mediators produced by the endothelial cell. Hypertension 62: 185–190, 1988.

    Google Scholar 

  29. Gupta, S., Cohen, R., and Sussman, I.: Endothelium-dependent inhibition of vascular NaK Atpase activity by high glucose. Diabetes 39: 31A, 1990.

    Google Scholar 

  30. Harris, K. H., and Macleod, K. M.: Influence of the endothelium on contractile responses of arteries from diabetic rats. Eur. J. Pharmacol. 153: 55–64, 1988.

    Article  PubMed  CAS  Google Scholar 

  31. Herman, W. H., and Teutsch, S. M.: Kidney diseases associated with diabetes. In: Diabetes in America, Diabetes Data Compiled 1984, edited by National Diabetes Data Group. Washington, DC: U.S. Government Printing Office, Nih Publication 85–1468, 1985, Chapter Xiv, pp. 1–31.

    Google Scholar 

  32. Horan, M. J.: Diabetes and hypertension. In: Diabetes in America, Diabetes Data Compiled 1984, edited by National Diabetes Data Group. Washington, DC: U.S. Government Printing Office, Nih Publication 85–1468, Chapter Xvii, pp. 1–22.

    Google Scholar 

  33. Ireland, J. T., Viberti, G. C., and Watkins, P. J.: The kidney and renal tract. In: Complications of Diabetes, 2 Ed., edited by H. Keen and J. Jarrett. London: E. J. Arnold, 1982, pp. 137–178.

    Google Scholar 

  34. Iwal, M., Yoshino, G., Matsushita, M., Morita, M., Matsuba, K., Kazumi, T., and Baba, S.: Abnormal lipoprotein composition in normolipidemic diabetic patients. Diabetes Care 13: 792–796, 1990.

    Article  Google Scholar 

  35. Jarrett, R. J.: Cardiovascular disease and hypertension in diabetes mellitus. Diabetes! Metab. Rev. 5: 547–557, 1989.

    Article  PubMed  CAS  Google Scholar 

  36. Jarrett, R. J., Mccartney, P., and Keen, H.: The Bedford survey: Ten year mortality rates in newly diagnosed diabetics, borderline diabetics and normoglycemic controls and risk indices for coronary heart disease in borderline diabetics. Diabetologia 22: 7984, 1982.

    Google Scholar 

  37. Jensen, T., Borchjohnson, K., Kofoed-Enevoldsen, A., and Deckert, T.: Coronary heart disease in young type I (insulin-dependent) diabetic patients with and without diabetic nephropathy: incidence and risk factors. Diabetologia 30: 144–148, 1987.

    Article  PubMed  CAS  Google Scholar 

  38. Kannel, W. B., and Mcgee, D. L.: Diabetes and cardiovascular disease: the Framingham Study. Jama 241: 2035–2038, 1979.

    Article  PubMed  CAS  Google Scholar 

  39. Kamata, K., Miyata, N., and Kasuya, Y.: Impairment of endothelium-dependent relaxation and changes in levels of cGmp in aorta from streptozotocin-induced diabetic rats. Br. J. Pharmacol. 97: 614–618, 1989.

    Article  PubMed  CAS  Google Scholar 

  40. Kern, T. S., and Engerman, R. L.: Arrest of glomerulopathy in diabetic dogs by improved glycemic control. Diabetes 39 (Suppl. 1): 34A, 1990.

    Google Scholar 

  41. Kinoshita, J. H., Datiles, M. B., Kador, P. F., and Robison, W. G.: Aldose reductase and diabetic eye complications. In: Ellenberg and Rifkins Diabetes Mellitus, Theory and Practice,4 Ed., edited by H. Rifkin and D. Porte. New York: Elsevier, 1990, pp. 264–278.

    Google Scholar 

  42. Klein, R., and Klein, B. E. K.: Vision disorders in diabetes. In: Diabetes in America, Diabetes Data Compiled 1984, edited by National Diabetes Data Group. Washington, DC: U.S. Government Printing Office, Nih Publication 85–1468, 1985, Chapter Xiii, pp. 1–36.

    Google Scholar 

  43. Klein, R., Klein, B. E. K., and Moss, S. E.: The Wisconsin Epidemiological Study of Diabetic Retinopathy. DiabeteslMetab. Reu. 5: 559–570, 1989.

    Article  CAS  Google Scholar 

  44. Knowles, H. C.: The problem of the relationship of the control of diabetes to the development of vascular disease. Trans. Am. Clin. Climatol. Assn. 76: 142–147, 1964.

    Google Scholar 

  45. Knuiman, M. W., Welborn, T. A., Mccann, U. S., Stanton, K. D., and Constable, I. J.: Prevalence of diabetic complications in relation to risk factors. Diabetes 35: 1332–1339, 1986.

    Article  PubMed  CAS  Google Scholar 

  46. Konner, E. M., Mcleod, D., and Marshall, J.: Diabetic eye disease. In: Complications of Diabetes, edited by H. Keen and J. Jarrett. London: E. J. Arnold, 1982, pp. 19–108.

    Google Scholar 

  47. Krolewski, A. S., Canessa, M., Warram, J. H., Laffel, L. M. B., Christlieb, A. R., Knowler, W. C., and Rand, L. I.: Predisposition to hypertension and susceptibility to renal disease in insulin-dependent diabetes mellitus. N. Engl. J. Med. 318: 140–145, 1988.

    Article  PubMed  CAS  Google Scholar 

  48. Krolewski, A. S., Kosinski, E. J., Warram, J. H., Letand, O. S., Busick, E., Asmal, A. C., Rand, L. I., Christlieb, A. R., Bradley, R. F., and Kahn, C. R.: Magnitude and determinants of coronary artery disease in juvenile-onset, insulin-dependent diabetes mellitus. Am. J. Cardiol. 59: 750–755, 1987.

    Article  PubMed  CAS  Google Scholar 

  49. Krolewski, A. S., Warram, J. H., Rand, L. I., and Kahn, C. R.: Epidemiological approach to the etiology of type I diabetes and its complications. N. Engl. J. Med. 317: 1390–1398, 1987.

    Article  PubMed  CAS  Google Scholar 

  50. Lee, T. S., Macgregor, L. C., Fluharty, S. J., and King, G. L.: Differential regulation of protein kinase C and (Na,K) adenosine triphosphatase activities by elevated glucose levels in retinal capillary endothelial cells. J. Clin. Invest. 83: 90–94, 1989.

    Article  PubMed  CAS  Google Scholar 

  51. Lee, T. S., Saltsman, K. A., Onashi, H., and King, G. L.: Activation of protein kinase C by elevation of glucose concentration. Proposal for a mechanism in the development of diabetic vascular complications. Proc. Natl. Acad. Sci. U.S.A. 86: 5141–5145, 1989.

    Article  PubMed  CAS  Google Scholar 

  52. Lesperance, F. A., James, W. A., and Judson, P. H.: The eye and diabetes mellitus. In: Ellenberg and Rifkins, Diabetes Mellitus, Theory and Practice, 4th Ed. Edited by H. Rifkin and D. Porte. New York: Elsevier, 1990, pp. 661–683.

    Google Scholar 

  53. Mangili, R., Bending, J. J., Scott, G., LI, L. K., Gupta, A., and Viberti, G. C.: Increased sodium-lithium countertransport activity in red cells of patients with insulin-dependent diabetes and nephropathy. N. Engl. J. Med. 318: 146–150, 1988.

    Article  PubMed  CAS  Google Scholar 

  54. Mauer, S. M., Steffes, M. W., Sutherland, D. E. R., Najarian, J. S., Michael, A. F., and Brown, D. M.: Studies of the rate of regression of the glomerular lesions in diabetic rats treated with pancreatic islet transplantation. Diabetes 24: 280–285, 1975.

    Article  PubMed  CAS  Google Scholar 

  55. Mogensen, C. E., and Anderson, M. J. F.: Increased kidney size and glomerular filtration rate in untreated juvenile diabetes: normalization by insulin treatment. Diabetologia 11: 221–224, 1975.

    Article  PubMed  CAS  Google Scholar 

  56. Mogensen, C. E., Schmitz, A., and Christensen, C. R.: Comparative renal pathophysiology relevant to Iddm and Niddm patients. Diabetes/Metab. Rev. 4: 453–483, 1988.

    Article  CAS  Google Scholar 

  57. Moran, A., Brown, D. M., Kim, Y., and Klein, D. J.: The effects of Igf-I and hyperglycemia on protein and proteoglycan synthesis in human fetal mesangial cells. Diabetes 39 (Suppl 11): 70A, 1990.

    Google Scholar 

  58. Mykkanen, L., Vusitupa, M., and Pyorala, K.: Asymptomatic hyperglycemia is associated with an increased prevalence of coronary heart disease in the elderly. Diabetes 39 (Suppl. 11): 38A, 1990.

    Google Scholar 

  59. Nathan, D. M., Singer, D. E., and Hurxthal, K.: The clinical information value of the glycosylated hemoglobin assay. N. Engl. J. Med. 310: 341–346, 1984.

    Article  PubMed  CAS  Google Scholar 

  60. Nishizuka, Y.: The role of protein kinase C in cell surface signal transduction and tumour promotion. Nature 308: 693–697, 1984.

    Article  PubMed  CAS  Google Scholar 

  61. Osterby, R.: Basement membrane morphology in diabetes mellitus. In: Ellenberg and Rifkins, Diabetes Mellitus, Theory and Practice, 4 Ed., edited by H. Rifkin and D. Porte. New York: Elsevier, 1990, pp. 220–233.

    Google Scholar 

  62. Panza, J. A., Quyyumi, A. A., Brush, J. E. JR., and Epstein, S. E.: Abnormal endothelium dependent vascular relaxation in patients with essential hypertension. N. Engl. J. Med. 233: 22–27, 1990.

    Article  Google Scholar 

  63. Parving, H. H., Viberti, G. C., Kan, H., Christiansen, J. S., and Lassen, N. A.: Hemodynamic factors in the genetics of diabetic microangiopathy. Metabolism 32: 943–949, 1983.

    Article  PubMed  CAS  Google Scholar 

  64. Perlmutter, J., Jacobs, J., Ziyadeg, F., Senesky, D., Simmons, D. A., Kern, E. F. D., and Goldfarb, S.: Reduced renal vasoconstrictive response to adenosine and reversal by aldose reductase inhibition in acute experimental diabetes. Clin. Res. 37: 583A, 1989.

    Google Scholar 

  65. Pirart, J.: Diabetes mellitus and its degenerative complications. A prospective study of 4400 patients observed between 1947 and 1973. Diabetes Care 1: 168–188, 252–263, 1978.

    Google Scholar 

  66. Ramsay, R. C., Goetz, F. C., Sutherland, D. E. R., Mauer, S. M., Robinson, L. L., Can-Trill, H. L., Knowblach, W. H., and Najarian, J. S.: Progression of diabetic retinopathy after pancreas transplantation for insulin-dependent diabetes mellitus. N. Engl. J. Med. 318: 208–214, 1988.

    CAS  Google Scholar 

  67. Rasch, R.: Studies on the prevention of glomerulopathy in diabetic rats. Acta Endocrinol. (Suppl. 242 ): 43–44, 1981.

    CAS  Google Scholar 

  68. Robertson, W. B., and Strong, J. P.: Atherosclerosis in persons with hypertension and diabetes mellitus. Lab. Invest. 18: 538–551, 1968.

    PubMed  CAS  Google Scholar 

  69. Robison, W. G., JR., Nagata, M., Laver, N., Hohman, T. C., and Konshita, J. H.: Diabetic-like retinopathy in rats prevented with an aldose reductase inhibitor. Invest. Ophthalmol. Vis. Sci. 30: 2285–2292, 1989.

    Google Scholar 

  70. Rosenstock, J., and Raskin, P.: Diabetes and its complications: blood glucose control vs. genetic susceptibility. Diabetes/Metab. Rev. 4: 417–436, 1988.

    Article  CAS  Google Scholar 

  71. Roy, S., Sala, R., Cagliero, E., and Lorenzi, M.: Overexpression of fibronectin induced by diabetes or high glucose: phenomenon with a memory. Proc. Natl. Acad. Sci. U.S.A. 87: 404–408, 1990.

    Article  PubMed  CAS  Google Scholar 

  72. Ruderman, N. B., and Haudenschild, C.: Diabetes as an atherogenic factor. Prog. Cardiovasc. Dis. 26: 373–412, 1984.

    Article  PubMed  CAS  Google Scholar 

  73. Seaquist, E. R., Goetz, F. C., Rich, S., and Barbosa, J.: Familial clustering of diabetic kidney disease. Evidence for genetic susceptibility to diabetic nephropathy. N. Engl. J. Med. 320: 1161–1165, 1989.

    Article  PubMed  CAS  Google Scholar 

  74. Saenz DE Tejada, I., Goldstein, I., Asadzo, I. K., Krane, R. J., and Cohen, R. A.: Impaired neurogenic and endothelium mediated relaxation of penile smooth muscle from diabetic men with impotence. N. Engl. J. Med. 320: 1025–1030, 1989.

    Article  Google Scholar 

  75. Simmons, D. A., Kern, E. F. O., Winegrad, A. I., and Martin, D. B.: Basal phosphatidylinositol turnover controls aortic (Na’/K’) Atpase activity. J. Clin. Invest. 77: 503–513, 1986.

    Article  PubMed  CAS  Google Scholar 

  76. Simmons, D. A., and Winegrad, A. I.: Mechanism of glucose induced (Na’/K’) Atpase inhibition in aortic wall of rabbits. Diabetologia 22: 402–408, 1989.

    Article  Google Scholar 

  77. Skyler, J. S.: Relations of metabolic control of diabetes mellitus to chronic complications. In: Ellenberg and Rifkins, Diabetes Mellitus, Theory and Practice, 4 Ed., edited by H. Rifkin and D. Porte. New York: Elsevier, 1990, pp. 856–868.

    Google Scholar 

  78. Stamler, J.: Epidemiology: established major risk factors and the primary prevention of coronary heart diseases. In: Cardiology, edited by W. Parmley and K. Chatterjee. Philadelphia: Lippincott, 1987, pp. 1–41.

    Google Scholar 

  79. Stout, R. W.: Blood glucose and atherosclerosis. Atherosclerosis 1: 227–234, 1981.

    CAS  Google Scholar 

  80. Tilton, R. G., Chang, K., Pugliese, G., Eades, D. M., Province, M. A., Sherman, W. R., Kilo, C., and Williamson, J. R.: Prevention of hemodynamic and vascular albumin filtration changes in diabetic rats by aldose reductase inhibitors. Diabetes 37: 1258–1270, 1989.

    Article  Google Scholar 

  81. Vane, J. R., Anggard, E. E., and Blotting, R. M.: Regulatory functions of the vascular endothelium. N. Engl. J. Med. 323: 27–36, 1990.

    Article  PubMed  CAS  Google Scholar 

  82. Viberti, G. C., and Walker, J. D.: Diabetic nephropathy: etiology and prevention. Diabetes/Metab. Rev. 4: 147–162, 1988.

    Article  CAS  Google Scholar 

  83. Williams, C. L., Heath, W., and Stramm, L.: Retinal pericyte proteoglycan metabolism: modulation by protein kinase C. Diabetes 39 (Suppl. 11): 32A, 1990.

    Google Scholar 

  84. Williamson, J. R., Tilton, R. G., Chang, K., and Kilo, C.: Basement membrane abnormalities in diabetes mellitus: relationship to clinical microangiopathy. Diabetes/Metab. Rev. 4: 339–369, 1988.

    Article  CAS  Google Scholar 

  85. Winegrad, A. I.: Does a common mechanism induce the diverse complications of diabetes? Diabetes 36: 396–406, 1987.

    PubMed  CAS  Google Scholar 

  86. Wiseman, M. J., Saunders, A. J., Keen, H., and Viberti, G. C.: Effect of blood glucose control on increased glomerular filtration rate and kidney size in insulin-dependent diabetes. N. Engl. J. Med. 312: 617–621, 1988.

    Article  Google Scholar 

  87. Wolf, B. A., Williamson, J. R., Easom, R. A., Chang, K., Sherman, W. R., and Turk, J.: Diacylglycerol accumulation and microvascular abnormalities induced by elevated glucose levels. J. Clin. Invest. 85: 482–490, 1990.

    Article  PubMed  CAS  Google Scholar 

  88. Witztum, J. L., Steinbrecher, U. P., Kesaniemi, Y. A., and Fisher, M.: Autoantibodies to glucosylated proteins in the plasma of patients with diabetes mellitus. Proc. Natl. Acad. Sci, Usa 81: 3204–3208, 1984.

    Article  PubMed  CAS  Google Scholar 

  89. Woodgett, J. R., Hunter, T., and Gould, K.: Protein kinase C and its role in cell growth. In: Cell Membranes: Methods and Reviews, edited by E. Elson. New York: Plenum Press, pp. 215–340, 1987.

    Google Scholar 

  90. World Health Organization Multinational Study OF Vascular Disease IN Diabetes: Prevalence of small vessel and large vessel disease in diabetic patients from 14 centers. Diabetologia 28: 615–640, 1985.

    Article  Google Scholar 

Download references

Authors
  1. Neil B. Ruderman
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Sandeep Gupta
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Ilene Sussman
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Diabetes and Metabolism Unit, Evans Memorial Department of Clinical Research and Department of Physiology, Boston University School of Medicine, Boston, Massachusetts, USA

    Neil Ruderman

  2. Department of Pathology, Washington University School of Medicine, St. Louis, Missouri, USA

    Joseph Williamson

  3. Diabetes Research Center and Departments of Medicine and Pathology, Albert Einstein College of Medicine, Bronx, New York, USA

    Michael Brownlee

Rights and permissions

Reprints and permissions

Copyright information

© 1992 American Physiological Society

About this chapter

Cite this chapter

Ruderman, N.B., Gupta, S., Sussman, I. (1992). Hyperglycemia, Diabetes, and Vascular Disease: An Overview. In: Ruderman, N., Williamson, J., Brownlee, M. (eds) Hyperglycemia, Diabetes, and Vascular Disease. Clinical Physiology Series. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-7524-8_1

Download citation

  • DOI: https://doi.org/10.1007/978-1-4614-7524-8_1

  • Publisher Name: Springer, New York, NY

  • Online ISBN: 978-1-4614-7524-8

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics

Search

Navigation