Pathogenesis and Progression of Microvascular and Macrovascular Complications in Diabetes

Impact of Chronic Hyperglycemia on Vascular Integrity

Diabetes mellitus is a chronic metabolic disorder characterized by persistent hyperglycemia, leading to a cascade of vascular complications affecting both microvasculature and macrovasculature.

Microvascular Complications

• Diabetic Retinopathy: Chronic hyperglycemia damages retinal blood vessels, leading to vision impairment.
• Diabetic Nephropathy: Persistent high glucose levels compromise kidney function, resulting in proteinuria and renal failure.
• Diabetic Neuropathy: Nerve damage due to vascular insufficiency causes pain, numbness, and motor dysfunction.

Macrovascular Complications

• Coronary Artery Disease: Increased atherosclerosis risk elevates the likelihood of myocardial infarction.
• Peripheral Arterial Disease: Compromised blood circulation leads to tissue ischemia and ulcers.
• Cerebrovascular Disease: Heightened risk of stroke due to endothelial dysfunction and thrombosis.

Pathogenesis

Chronic hyperglycemia triggers oxidative stress, inflammation, and endothelial dysfunction. Advanced glycation end-products (AGEs) play a crucial role in tissue injury and vascular deterioration.

Management Strategies

• Glycemic control through insulin therapy and oral hypoglycemic agents.
• Lipid-lowering agents to reduce atherosclerosis risk.
• Regular screening for early detection of complications.

Maintaining optimal blood glucose levels and lifestyle modifications are essential to mitigate these vascular complications.