Pathogenesis and Progression of Microvascular and Macrovascular Complications in Diabetes

Mechanisms of Microvascular Damage in Diabetes

Diabetes mellitus is associated with both microvascular and macrovascular complications. Microvascular damage primarily affects small blood vessels, leading to complications such as diabetic retinopathy, nephropathy, and neuropathy.

Pathogenesis of Microvascular Complications

• Hyperglycemia-induced oxidative stress: Excess glucose generates reactive oxygen species (ROS), leading to endothelial dysfunction.
• Advanced Glycation End-products (AGEs): Hyperglycemia accelerates non-enzymatic glycation, contributing to basement membrane thickening and vascular permeability.
• Inflammatory pathways: Chronic inflammation exacerbates vascular injury, increasing the risk of tissue ischemia.

Macrovascular Complications in Diabetes

Macrovascular complications involve large arteries and can lead to cardiovascular disease, stroke, and peripheral artery disease.

Strategies for Prevention

Strict glycemic control, lifestyle modifications, and pharmacological interventions targeting inflammation and oxidative stress help mitigate these complications.