Microvascular Dysfunction and Hyperglycemia: A Vicious Cycle With Widespread Consequences

Coen D. A. Stehouwer*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

127 Citations (Web of Science)

Abstract

Microvascular and metabolic physiology are tightly linked. This Perspective reviews evidence that 1) the relationship between hyperglycemia and microvascular dysfunction (MVD) is bidirectional and constitutes a vicious cycle; 2) MVD in diabetes affects many, if not all, organs, which may play a role in diabetes-associated comorbidities such as depression and cognitive impairment; and 3) MVD precedes, and contributes to, hyperglycemia in type 2 diabetes (T2D) through impairment of insulin-mediated glucose disposal and, possibly, insulin secretion. Obesity and adverse early-life exposures are important drivers of MVD. MVD can be improved through weight loss (in obesity) and through exercise. Pharmacological interventions to improve MVD are an active area of investigation.
Original languageEnglish
Pages (from-to)1729-1741
Number of pages13
JournalDiabetes
Volume67
Issue number9
DOIs
Publication statusPublished - 1 Sep 2018

Keywords

  • RETINAL VASCULAR CALIBER
  • MUSCLE RESISTANCE ARTERIES
  • URINARY ALBUMIN EXCRETION
  • LIFE-STYLE INTERVENTION
  • INDUCED CAPILLARY RECRUITMENT
  • ADIPOSE-TISSUE INFLAMMATION
  • DEPENDENT DIABETES-MELLITUS
  • RANDOMIZED CONTROLLED-TRIAL
  • SMALL VESSEL DISEASE
  • INSULIN-RESISTANCE

Cite this