Hostname: page-component-848d4c4894-p2v8j Total loading time: 0.001 Render date: 2024-05-13T16:37:10.424Z Has data issue: false hasContentIssue false
  • English
  • Français

Chronic complications in diabetes mellitus

Published online by Cambridge University Press:  09 March 2007

Ryuichi Kikkawa
Ryuichi Kikkawa*
Affiliation:
Third Department of Medicine, Shiga University of Medical Science, Otsu, Shiga, 520–2129, Japan
*
*Corresponding author: Ryuichi Kikkawa, tel 81 77 548 2221, fax 81 77 543 3858, email kikkawa@belle.shiga-med.ac.jp
Rights & Permissions [Opens in a new window]

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

Diabetes mellitus is one of the most prevalent diseases among adult population in Japan. The persistent hyperglycemia is responsible for the appearance of various organ and tissue damage in diabetic subjects. Eyes, kidneys and peripheral nerves are frequently damaged due to diabetes-specific alteration in microvessels. Furthermore, large vessels are also damaged causing severe diseases such as myocardial infarction, cerebral infarction and gangrene. The pathogenesis of these alterations in small and large vessels has been extensively studied and various metabolic abnormalities induced by hyperglycemia are proposed to play a major role in the development of these diabetic vascular complications. Among those metabolic abnormalities, the activation of the diacyl glycerol-protein kinase C pathway has been proposed to play a pivotal role in the pathogenesis of not only microvascular complications but also macrovascular complications. The beneficial effect of a protein kinase C inhibitor on renal, retinal and atherosclerotic lesions in diabetic animal models may support this notion. The results of several large-scale clinical trials have confirmed the efficacy of glycemic control as well as blood pressure control in the management of diabetic complications. It is a prerequisite, therefore, to obtain near-normal glycemic and blood pressure control in order to prevent the appearance of diabetic complications and also suppress their progression. In this aspect nutritional consideration may be an important way to improve the quality of these managements.

Keywords

Diabetic complicationsProtein kinase CGlycationOxidative stressGlycemic controlBlood pressure control
Type
Research Article
Information
British Journal of Nutrition , Volume 84 , Issue S2 , December 2000 , pp. S183 - S185
Copyright
Copyright © The Nutrition Society 2000

References

Brownlee, M, Cerami, A & Vlassara, H (1988) Advanced glycosylation end products in tissue and the biochemical basis of diabetic complications. New England Journal of Medicine 318, 1315–1321.Google ScholarPubMed
Ishii, H, Jirousek, MR, Koya, D, Takagi, C, Xia, P, Clermont, A, Bursell, SJE, Kern, TS, Ballas, LM, Heath, WF, Stramm, LE, Feener, EP & King, GL (1996) Amelioration of vascular dysfunctions in diabetic rats by an oral PKC an inhibitor. Science 272, 728–731.CrossRefGoogle Scholar
Japanese Society for Dialysis Therapy (2000) An overview of dialysis treatment in Japan (as of 31 December 1998). Journal of Japanese Society for Dialysis Therapy 33, 1–27.Google Scholar
Kikkawa, R & Haneda, M (1997) Pathogenesis of diabetic nephropathy. Clinical and Experimental Nephrology 1, 3–11.CrossRefGoogle Scholar
Koya, D, Haneda, M, Nakagawa, H, Isshiki, K, Sato, H, Maeda, S, Sugimoto, T, Yasuda, H, Kashiwagi, A, Ways, K, King, GL & Kikkawa, R (2000) Amelioration of accelerated diabetic mesangial expansion by treatment with a PKC beta inhibitor in diabetic db/db mice, a rodent model for type 2 diabetes. FASEB Journal 13, 2329–2337.CrossRefGoogle Scholar
Nishio, Y, Kashiwagi, A, Taki, H, Shinozaki, K, Maeno, Y, Kojima, H, Maegawa, H, Haneda, M, Hidaka, H, Yasuda, H, Horiike, K & Kikkawa, R (1998) Altered activities of transcription factors and their related gene expression in cardiac tissues of diabetic rats. Diabetes 47, 1318–1325.CrossRefGoogle ScholarPubMed
Ohkubo, Y, Kishikawa, H, Araki, E, Miyata, T, Isami, S, Motoyoshi, S, Kojima, Y, Furuyoshi, N & Shichiri, M (1995) Intensive insulin therapy prevents the progression of diabetic microvascular complications in Japanese patients with non-insulin-dependent diabetes mellitus: a randomized prospective 6-year study. Diabetes Research and Clinical Practice 28, 103–117.CrossRefGoogle ScholarPubMed
Diabetes Control and Complications ThaI Research Group (1993) The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin dependent diabetes mellitus. New England Journal Medicine 329, 977–986.CrossRefGoogle Scholar
UK Prospective Diabetes Study Group (1998) Tight blood pressure control and risk of macrovascular and microvascular complications in type 2 diabetes: UKPDS 38. British Medical Journal 317, 705–713.Google Scholar