Diabetic Microvascular Complications: Possible Targets for Improved Macrovascular Outcomes
View/ Open
Author
Bayliss, George
Published Version
https://doi.org/10.2147/IJNRD.S14716Metadata
Show full item recordCitation
D'Elia, John A, George Bayliss, Bijan Roshan, Manish Maski, Ray E Gleason, and Larry A Weinrauch. 2011. Diabetic microvascular complications: Possible targets for improved macrovascular outcomes. International Journal of Nephrology and Renovascular Disease 4: 1-15.Abstract
The results of recent outcome trials challenge hypotheses that tight control of both glycohemoglobin and blood pressure diminishes macrovascular events and survival among type 2 diabetic patients. Relevant questions exist regarding the adequacy of glycohemoglobin alone as a measure of diabetes control. Are we ignoring mechanisms of vasculotoxicity (profibrosis, altered angiogenesis, hypertrophy, hyperplasia, and endothelial injury) inherent in current antihyperglycemic medications? Is the polypharmacy for lowering cholesterol, triglyceride, glucose, and systolic blood pressure producing drug interactions that are too complex to be clinically identified? We review angiotensin-aldosterone mechanisms of tissue injury that magnify microvascular damage caused by hyperglycemia and hypertension. Many studies describe interruption of these mechanisms, without hemodynamic consequence, in the preservation of function in type 1 diabetes. Possible interactions between the renin-angiotensin-aldosterone system and physiologic glycemic control (through pulsatile insulin release) suggest opportunities for further clinical investigation.Other Sources
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3108788/pdf/Terms of Use
This article is made available under the terms and conditions applicable to Other Posted Material, as set forth at http://nrs.harvard.edu/urn-3:HUL.InstRepos:dash.current.terms-of-use#LAACitable link to this page
http://nrs.harvard.edu/urn-3:HUL.InstRepos:8160877
Collections
- HMS Scholarly Articles [17922]
Contact administrator regarding this item (to report mistakes or request changes)