Diabetes and vascular disease: Pathophysiology, clinical consequences, and medical therapy: Part i

Francesco Paneni, Joshua A. Beckman, Mark A. Creager, Francesco Cosentino

Research output: Contribution to journalReview articlepeer-review

617 Scopus citations


Hyperglycemia and insulin resistance are key players in the development of atherosclerosis and its complications. A large body of evidence suggest that metabolic abnormalities cause overproduction of reactive oxygen species (ROS). In turn, ROS, via endothelial dysfunction and inflammation, play a major role in precipitating diabetic vascular disease. A better understanding of ROS-generating pathways may provide the basis to develop novel therapeutic strategies against vascular complications in this setting. Part I of this review will focus on the most current advances in the pathophysiological mechanisms of vascular disease: (i) emerging role of endothelium in obesity-induced insulin resistance; (ii) hyperglycemia-dependent microRNAs deregulation and impairment of vascular repair capacities; (iii) alterations of coagulation, platelet reactivity, and microparticle release; (iv) epigenetic-driven transcription of ROS-generating and proinflammatory genes. Taken together these novel insights point to the development of mechanism-based therapeutic strategies as a promising option to prevent cardiovascular complications in diabetes.

Original languageEnglish (US)
Pages (from-to)2436-2446
Number of pages11
JournalEuropean heart journal
Issue number31
StatePublished - Aug 14 2013
Externally publishedYes


  • Diabetes
  • Pathophysiology
  • Vascular disease

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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