Vascular Endothelium and Diabetes Mellitus

  • Robert S. Bar


Diabetes mellitus is a disease complex defined by abnormalities of glucose homeostasis and characterized by a group of chronic complications that affect the function of the eyes (retinopathy), kidneys (nephropathy), peripheral nerves (neuropathy), large blood vessels (atherosclerosis), and microvessels (microangiopathy). Indeed, the vascular dysfunction(s) in diabetes may underlie all of the chronic complications of the disease. These complications account for the vast majority of morbidity and mortality that accompanies diabetes, with atherosclerosis underlying the susceptibility to myocardial infarction and stroke, and the microvascular disease underlying retinopathy, nephropathy, and, perhaps, neuropathy. Diabetes mellitus is divided into two general categories, type I [insulin-dependent diabetes mellitus (IDDM)] and type II [non-insulin-dependent diabetes mellitus (NIDDM)]. The general characteristics of type I and type II diabetes are outlined in Table 1. Both type I and type II patients have similar complications, although the frequency of each complication differs between the two groups, with type I patients having a much greater incidence of microvascular complications (nephropathy and retinopathy) and type II patients having a somewhat higher frequency of microvascular complications that are associated with atherosclerosis. Although the precise etiologies of type I and II diabetes, as well as the causes of the diabetic complications, are not known, abnormalities of the vascular endothelium have been shown to occur early in the disease and have been implicated in the pathogenesis of chronic complications in this complex illness.


Endothelial Cell Vascular Endothelium Human Endothelial Cell Aldose Reductase Vascular Basement Membrane 
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Copyright information

© Springer Science+Business Media New York 1992

Authors and Affiliations

  • Robert S. Bar
    • 1
  1. 1.Diabetes and Endocrinology Research CenterUniversity of IowaIowa CityUSA

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