DIABETES MELLITUS AND MECHANISM OF CHRONIC COMPLICATIONS: REVIEW ARTICLE

Dr. Nidhi S. Patel, Dr. Viren N. Naik* and Dr. C. B. Tripathi

ABSTRACT

Diabetes mellitus (DM) is comprises a group of common metabolic disorders that share the phenotype of hyperglycemia. Complex interaction of genetics, environmental factors and sedentary lifestyle are responsible for its development. Metabolic derangement related with DM induces secondary pathophysiologic changes in multiple organ systems which impose a tremendous burden on the individual with diabetes and the health care system of the country. Worldwide 415 million adults have diabetes and this will rise to 642 million by 2040. In chronic stage DM affects many organ systems, and its complications increase the risk for morbidity and mortality. Many physiological impairments including platelet hyper-reactivity, a tendency for negative arterial remodeling, impaired fibrinolysis coupled with a tendency for thrombosis and coagulation, increased inflammation, and endothelial dysfunction, increases the risk of atherosclerotic vascular disease and other chronic complications like retinopathy, neuropathy. Among these, endothelial dysfunction is an important responsible factor for these pathological manifestations. Various mechanisms have been described for endothelial dysfunction in DM but, most likely are metabolic derangements such as hyperglycemia, excess liberation of free fatty acids (FFAs), and insulin resistance. Additional to these oxidative stress induced reactive oxygen species; inflammation and thrombosis also accentuate endothelial dysfunction. This review article describes mechanism associated with chronic complications of DM in brief.

Keywords: Diabetes mellitus, chronic complications, metabolic derangement, endothelial dysfunction.