Diabetes microvascular complications-A clinical update

Abstract

Background: The purpose of this study is to summarise the empirical evidence addressing diabetes microvascular complications and management. The effects of diabetes mellitus include long-term damage, dysfunction and failure of various organs. Microvascular disease tends to occur predominantly in tissues where glucose uptake is independent of insulin activity because these tissues are exposed to glucose levels that correlate very closely with blood glucose levels. These metabolic injuries cause altered blood flow and changes in endothelial permeability, extravascular protein deposition and coagulation resulting in organ dysfunction which in turn lead to microvascular complications.

Method: A systematic search of the literature from 2000 to 2016 was conducted using four databases (Medline, Pubmed, Cochrane central and Google scholar) using search terms such as diabetic microvascular complications', pathogenesis, screening, risk factors, pharmacological and non-pharmacological interventions and management.

Results: The current evidence supports a direct relationship between blood pressure (BP) and glycaemic control and progression of nephropathy and retinopathy. These are now considered as independent risk factors for microvascular disease progression. New fields of research addressing new drugs as potential therapeutic targets of the future will be presented.

Conclusion: The prevention of microvascular disease involves paying attention to aggravating risk factors and implementing screening programmes to improve early detection.

Keywords: Management; Nephropathy; Neuropathy; Pathogenesis; Retinopathy.