The Vasculature in Prediabetes.

Wasserman DH, Wang TJ, Brown NJ
Circ Res. 2018 122 (8): 1135-1150

PMID: 29650631 · PMCID: PMC5901903 · DOI:10.1161/CIRCRESAHA.118.311912

The frequency of prediabetes is increasing as the prevalence of obesity rises worldwide. In prediabetes, hyperglycemia, insulin resistance, and inflammation and metabolic derangements associated with concomitant obesity cause endothelial vasodilator and fibrinolytic dysfunction, leading to increased risk of cardiovascular and renal disease. Importantly, the microvasculature affects insulin sensitivity by affecting the delivery of insulin and glucose to skeletal muscle; thus, endothelial dysfunction and extracellular matrix remodeling promote the progression from prediabetes to diabetes mellitus. Weight loss is the mainstay of treatment in prediabetes, but therapies that improved endothelial function and vasodilation may not only prevent cardiovascular disease but also slow progression to diabetes mellitus.

© 2018 American Heart Association, Inc.

MeSH Terms (28)

Angiotensin-Converting Enzyme Inhibitors Animals Blood Vessels Cardiovascular Diseases Combined Modality Therapy Diabetes Mellitus, Type 2 Diet, Reducing Disease Progression Endothelium, Vascular Extracellular Matrix Fatty Acids, Nonesterified Fibrinolysis Glucose Humans Hyperglycemia Hypoglycemic Agents Inflammation Insulin Resistance Life Style Metabolic Syndrome Mice Microcirculation MicroRNAs Muscle, Skeletal Obesity Prediabetic State Risk Weight Loss

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