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Chronic diabetic complications: the body's adaptive response to hyperglycemia gone awry?

Abstract
In the last two decades, diabetes mellitus has reached epidemic proportions in the United States. Most of the recent increase in prevalence of diabetes involves type 2 disease and is a result of an alarming increase in prevalence of obesity, although type 1 diabetes may also be on the rise. Advances in treatment have essentially eliminated ketoacidosis as a cause of death and led to better glycemic control than ever before. Consequently, diabetics now live a longer life, allowing many of them to develop the chronic complications of the disease. Here we review the evidence that a maladaptive response to hyperglycemia contributes to diabetic neuropathy, a major microvascular complication. We postulate that the same response may also be the culprit for the other chronic complications of diabetes.
AuthorsLawrence Chan, Tomoya Terashima, Mineko Fujimiya, Hideto Kojima
JournalTransactions of the American Clinical and Climatological Association (Trans Am Clin Climatol Assoc) Vol. 117 Pg. 341-51; discussion 351-2 ( 2006) ISSN: 0065-7778 [Print] United States
PMID18528485 (Publication Type: Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't, Review)
Chemical References
  • Proinsulin
Topics
  • Animals
  • Bone Marrow Cells (metabolism)
  • Diabetes Complications (etiology, metabolism)
  • Diabetes Mellitus, Type 1 (therapy)
  • Diabetic Neuropathies (etiology, metabolism)
  • Genetic Therapy
  • Humans
  • Hyperglycemia (metabolism)
  • Proinsulin (biosynthesis)
  • Tissue Distribution

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