Microvascular Dysfunction and Hyperglycemia: A Vicious Cycle With Widespread Consequences

Coen D. A. Stehouwer

doi:10.2337/dbi17-0044

Microvascular Dysfunction and Hyperglycemia: A Vicious Cycle With Widespread Consequences

Coen D. A. Stehouwer^*

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

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 language	English
Pages (from-to)	1729-1741
Number of pages	13
Journal	Diabetes
Volume	67
Issue number	9
DOIs	https://doi.org/10.2337/dbi17-0044
Publication status	Published - 1 Sept 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

Access to Document

10.2337/dbi17-0044

Cite this

@article{2f5b3819755d437c8ce1c7e68de791e5,

title = "Microvascular Dysfunction and Hyperglycemia: A Vicious Cycle With Widespread Consequences",

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.",

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",

author = "Stehouwer, {Coen D. A.}",

year = "2018",

month = sep,

day = "1",

doi = "10.2337/dbi17-0044",

language = "English",

volume = "67",

pages = "1729--1741",

journal = "Diabetes",

issn = "0012-1797",

publisher = "American Diabetes Association",

number = "9",

}

TY - JOUR

T1 - Microvascular Dysfunction and Hyperglycemia: A Vicious Cycle With Widespread Consequences

AU - Stehouwer, Coen D. A.

PY - 2018/9/1

Y1 - 2018/9/1

N2 - 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.

AB - 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.

KW - RETINAL VASCULAR CALIBER

KW - MUSCLE RESISTANCE ARTERIES

KW - URINARY ALBUMIN EXCRETION

KW - LIFE-STYLE INTERVENTION

KW - INDUCED CAPILLARY RECRUITMENT

KW - ADIPOSE-TISSUE INFLAMMATION

KW - DEPENDENT DIABETES-MELLITUS

KW - RANDOMIZED CONTROLLED-TRIAL

KW - SMALL VESSEL DISEASE

KW - INSULIN-RESISTANCE

U2 - 10.2337/dbi17-0044

DO - 10.2337/dbi17-0044

M3 - Article

C2 - 30135134

SN - 0012-1797

VL - 67

SP - 1729

EP - 1741

JO - Diabetes

JF - Diabetes

IS - 9

ER -

Microvascular Dysfunction and Hyperglycemia: A Vicious Cycle With Widespread Consequences

Abstract

Keywords

Access to Document

Fingerprint

Cite this