Titre du document / Document title

Makroangiopathie bei Diabetes mellitus = Macroangiopathy in diabetes mellitus

Auteur(s) / Author(s)

BIRRER M. ⁽¹⁾ ;

Affiliation(s) du ou des auteurs / Author(s) Affiliation(s)

⁽¹⁾ Schweizerisches Herz-und Gefässzentrum, Inselspital Bern, SUISSE

Résumé / Abstract

giopathy in diabetes mellitus In patients with diabetic angiopathy until today, no histological nor histochemical evidence has been found to define a specific type of diabetic arteriopathy. Consequently, diabetic arteriosclerosis is considered as a more serious form of atherosclerosis characterized by its premature onset. Hyperglycemia is assumed to be the crucial pathophysiological cause of the development of macro-and microangiopathy in diabetes mellitus. Apparently, hyperglycemia has a direct toxic influence on the arterial wall by increased accumulation of irreversible glycosylation end products, and secondly, it provokes endothelial dysfunction. The frequently occurring ulcerations of the diabetic foot are primarily caused by neuropathy; however, peripheral vascular disease (PVD) is often associated. The risk of suffering from PVD in diabetic patients is approximately four-fold. Usually, the distal segments of the lower leg arteries are concerned, where reconstructive intervention is complicated or even impossible. Diabetes is considered as an independent risk factor for cardio- and cerebrovascular diseases with almost twice as high rates for recurrent myocardial infarction, and a 3.7 fold higher relative risk for stroke in diabetic, compared to non-diabetic patients. This review looks at the correlations between hyperglycemia and arteriosclerosis, but also the treatment options in diabetic patients. Until now, there is no evidence for an association between an optimal control of blood glucose levels and a decrease in the risk of coronary heart disease, stroke, or PVD. In contrast, an attenuation of microvascular lesions is achieved by stringent control of blood glucose levels. Thus, although the development of macroangiopathy may not be significantly influenced, the conduction of a stringent control regimen of plasmatic glucose levels is advisable.

Revue / Journal Title

VASA   ISSN 0301-1526   CODEN VASAAH 

Source / Source

2001, vol. 30, n^o3, pp. 168-174 (80 ref.)

Langue / Language

Allemand

Editeur / Publisher

Huber, Bern, SUISSE  (1972) (Revue)

Mots-clés anglais / English Keywords

Diabetes mellitus ; Occlusive arterial disease ; Coronary heart disease ; Stroke ; Macroangiopathy ; Prognosis ; Complication ; Human ; Endocrinopathy ; Cardiovascular disease ; Vascular disease ; Arterial disease ; Nervous system diseases ; Central nervous system disease ; Cerebral disorder ; Cerebrovascular disease ;

Mots-clés français / French Keywords

Diabète ; Artériopathie oblitérante ; Cardiopathie coronaire ; Accident cérébrovasculaire ; Macroangiopathie ; Pronostic ; Complication ; Homme ; Endocrinopathie ; Appareil circulatoire pathologie ; Vaisseau sanguin pathologie ; Artère pathologie ; Système nerveux pathologie ; Système nerveux central pathologie ; Encéphale pathologie ; Cérébrovasculaire pathologie ;

Mots-clés espagnols / Spanish Keywords

Diabetes ; Arteriopatía oclusiva ; Cardiopatía coronaria ; Accidente cerebrovascular ; Macroangiopatía ; Pronóstico ; Complicación ; Hombre ; Endocrinopatía ; Aparato circulatorio patología ; Vaso sanguíneo patología ; Arteria patología ; Sistema nervioso patología ; Sistema nervosio central patología ; Encéfalo patología ; Vaso sanguíneo encéfalo patología ;

Localisation / Location

INIST-CNRS, Cote INIST : 10984, 35400009945115.0030