Treatments focused directly on the arterial wall represent a priority for preventing microvascular and macrovascular complications in patients with diabetes mellitus.
Do treatments targeting arterial wall dysfunction prevent vascular complications in patients with Diabetes Mellitus?
Treatments directly targeting arterial wall dysfunction may be a priority for preventing microvascular and macrovascular complications in patients with diabetes mellitus.
In Diabetes Mellitus (DM), hyperglycaemia and insulin resistance progressively lead to both microvascular and macrovascular complications. Whereas the incidence of microvascular complications is closely related to tight glycaemic control, this does not apply to macrovascular complications. Hyperglycaemia influences many interweaving molecular pathways that initially lead to increased oxidative stress, increased inflammation and endothelial dysfunction. The latter represents the initial in both types of vascular complications; it represents the "obligatory damage" in microvascular complications development and only "introductory damage" in macrovascular complications development. Other risk factors, such as arterial hypertension and dyslipidaemia, also play an important role in the progression of macrovascular complications. All these effects accumulate and lead to functional and structural arterial wall damage. In the end, all factors combined lead to the promotion of atherosclerosis and consequently major adverse cardiovascular events. If we accept the pivotal role of vascular wall impairment in the pathogenesis and progression of microvascular and macrovascular complications, treatment focused directly on the arterial wall should be one of the priorities in prevention of vascular complications in patients with DM. In this review, an innovative approach aimed at improving arterial wall dysfunction is described, which may show efficacy in clinical studies. In addition, the potential protective effects of current treatment approaches targeting the arterial wall are summarised.
Lunder et al. (Fri,) conducted a review in Diabetes Mellitus. Treatment focused directly on the arterial wall was evaluated. Treatments focused directly on the arterial wall represent a priority for preventing microvascular and macrovascular complications in patients with diabetes mellitus.