The role of oxidative stress in the pathophysiology of diabetic cardiomyopathy: Crosstalk of inflammatory pathways

Aims: Diabetic cardiomyopathy (DCM) is a major complication of diabetes mellitus (DM) leading to increased morbidity and mortality. Oxidative stress, resulting from an imbalance between reactive oxygen species (ROS) production and antioxidant defenses, plays a central role in DCM pathogenesis. Data Synthesis: This narrative review was conducted through a comprehensive literature search of major scientific databases, including PubMed, Scopus, and Web of Science, using keywords related to oxidative stress, inflammation, and diabetic cardiomyopathy. Peer-reviewed experimental and translational studies were critically analyzed and synthesized to elucidate key molecular mechanisms. Conclusions: This review highlights the molecular interplay between oxidative stress and inflammatory pathways—including Nrf2, NF-κB, and Sirt1 signaling—in promoting myocardial fibrosis, apoptosis, and dysfunction. Furthermore, therapeutic strategies targeting oxidative stress and inflammation, such as natural antioxidants and Nrf2 activators, show promise in mitigating DCM progression. Understanding these mechanisms provides new insights into potential interventions to prevent and treat diabetic heart disease.