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Arch Hellen Med, 23(2), March-April 2006, 131-139


Mechanisms of the complications of diabetes: Newer aspects

1st Department of Propedeutic Medicine, Medical School, University of Athens, Diabetes Centre, "Laiko" General Hospital, Athens, Greece

Hyperglycemia is the basic metabolic disturbance in patients with diabetes. The chronic complications of the disease are associated with both the duration and the degree of hyperglycemia. At the cellular level, increased blood glucose causes tissue injuries by one or more of the following mechanisms: (a) increased glucose metabolism through the polyol pathway; (b) increased production of end-glycation products; (c) activation of the protein kinase-C; (d) increased activation of the hexosamine pathway, and (e) oxidative stress and damage of the tissues. The results of recent studies suggest that the first four mechanisms are attributable to mitochondrial overproduction of hydrogen superoxide as a result of excess glucose metabolism. This hypothesis attempts to explain and unify the mechanisms underlying glucose induced tissue damage in diabetes.

Key words: Diabetes mellitus, Macroangiopathic complications, Microangiopathic complications, Pathogenesis of complications.

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