Journal Article

Endothelial dysfunction and platelet hyperactivity in type 2 diabetes mellitus: molecular insights and therapeutic strategies

Singh, Jatinder, Kaur, Raminderjit, Kaur, Manpreet

2018

Overview

The incidence and prevalence of diabetes mellitus is rapidly increasing worldwide at an alarming rate. Type 2 diabetes mellitus (T2DM) is the most prevalent form of diabetes, accounting for approximately 90–95% of the total diabetes cases worldwide. Besides affecting the ability of body to use glucose, it is associated with micro-vascular and macro-vascular complications. Augmented atherosclerosis is documented to be the key factor leading to vascular complications in T2DM patients. The metabolic milieu of T2DM, including insulin resistance, hyperglycemia and release of excess free fatty acids, along with other metabolic abnormalities affects vascular wall by a series of events including endothelial dysfunction, platelet hyperactivity, oxidative stress and low-grade inflammation. Activation of these events further enhances vasoconstriction and promotes thrombus formation, ultimately resulting in the development of atherosclerosis. All these evidences are supported by the clinical trials reporting the importance of endothelial dysfunction and platelet hyperactivity in the pathogenesis of atherosclerotic vascular complications. In this review, an attempt has been made to comprehensively compile updated information available in context of endothelial and platelet dysfunction in T2DM.

• Publisher: BioMed Central,Springer Nature B.V,BMC
• Subject: Angiology / Animals / Anticoagulants / Arteriosclerosis / Aspirin / Atherosclerosis / Atherosclerosis - blood / Atherosclerosis - drug therapy / Atherosclerosis - epidemiology / Atherosclerosis - physiopathology / Biomarkers - blood / Blood clots / Blood Glucose - metabolism / Blood platelets / Blood Platelets - drug effects / Blood Platelets - metabolism / Cardiology / Cardiovascular disease / Clinical medicine / Clinical trials / Diabetes / Diabetes mellitus / Diabetes mellitus (non-insulin dependent) / Diabetes Mellitus, Type 2 - blood / Diabetes Mellitus, Type 2 - drug therapy / Diabetes Mellitus, Type 2 - epidemiology / Diabetes Mellitus, Type 2 - physiopathology / Diabetic Angiopathies - blood / Diabetic Angiopathies - drug therapy / Diabetic Angiopathies - epidemiology / Diabetic Angiopathies - physiopathology / Diabetic retinopathy / Disease prevention / Endothelium / Endothelium, Vascular - drug effects / Endothelium, Vascular - metabolism / Endothelium, Vascular - physiopathology / Fatty acids / Fibrinolytic Agents - therapeutic use / Humans / Hyperactivity / Hyperglycemia / Hypoglycemic Agents - therapeutic use / Inflammation / Inflammation Mediators - blood / Insulin / Insulin resistance / Medicine / Medicine & Public Health / Metabolism / Oxidative Stress / Pathogenesis / Physicians / Platelet Activation - drug effects / Platelet Aggregation Inhibitors - therapeutic use / Platelets / Review / Smooth muscle / Systematic review / Thrombosis / Thrombosis - blood / Thrombosis - drug therapy / Thrombosis - epidemiology / Thrombosis - physiopathology / Vascular complications / Vasoconstriction / Vasoconstriction - drug effects