Vascular complications in diabetes: Old messages, new thoughts
Open accessAbstract
In parallel with the growing diabetes pandemic, there is an increasing burden of micro- and macrovascular complications, occurring in the majority of patients. The identification of a number of synergistic accelerators of disease, providing therapeutic pathways, has stabilised the incidence of complications in most western nations. However, the primary instigators of diabetic complications and, thus, prevention strategies, remain elusive. This has necessitated a refocus on natural history studies, where tissue and plasma samples are sequentially taken to determine when and how disease initiates. In addition, recent Phase III trials, wherein the pleiotropic effects of compounds were arguably as beneficial as their glucose-lowering capacity in slowing the progression of complications, have identified knowledge gaps. Recently the influence of other widely recognised pathological pathways, such as mitochondrial production of reactive oxygen species, has been challenged, highlighting the need for a diverse and robust global research effort to ascertain viable therapeutic targets. Technological advances, such as -omics, high-resolution imaging and computational modelling, are providing opportunities for strengthening and re-evaluating research findings. Newer areas such as epigenetics, energetics and the increasing scrutiny of our synergistic inhabitants, the microbiota, also offer novel targets as biomarkers. Ultimately, however, this field requires concerted lobbying to support all facets of diabetes research.
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Mitochondrial dynamics plays a pivotal role in endothelial dysfunction during macrovascular complications.
“A line of evidence indicates that mitochondrial dynamics plays a pivotal role in endothelial dysfunction during macrovascular complications [220,221].”
From AMPK, Mitochondrial Function, and Cardiovascular Disease (2020) · cites this paper as [220]
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- Authors
- Forbes, J. M., & Fotheringham, A. K.
- Affiliations
- Translational Research Institute (AU)
- Corresponding author
- Forbes, Josephine M.
- Venue
- Diabetologia
- Published
- 2017-07-19
- Volume
- 60
- Issue
- 11
- Pages
- 2129-2138
- ISSN
- 0012-186X (ISSN-L)
- 1432-0428
- OpenAlex
- W2737042056
- Cited by
- 106
- References
- 56
- Citations by year
- 2026: 3 · 2025: 10 · 2024: 10 · 2023: 6 · 2022: 14 · 2021: 18 · 2020: 15 · 2019: 8 · 2018: 20 · 2017: 2
- FWCI
- 1.79
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Diabetologia (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Health and Medical Research Council (1102935)
- Mater Foundation (N/A)
- Australian Postgraduate Award (N/A)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Clinical Biochemistry › Advanced Glycation End Products research
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Keywords
- diabetic vascular complications, diabetic microvascular complications, diabetic macrovascular complications, natural history of disease, disease initiation, pleiotropy, reactive oxygen species, mitochondrial dysfunction, therapeutic target, biomarkers, epigenetics, gut microbiota, energetics, omics, high-resolution imaging, computational modelling, diabetes research funding
- MeSH terms
- Cardiovascular Diseases, Diabetic Nephropathies, Diabetic Neuropathies, Diabetic Retinopathy, Humans
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