Cardiovascular complications of diabetes: recent insights in pathophysiology and therapeutics

Abstract

Cardiovascular complications represent the principal cause of death in patients with Type 2 diabetes. It is therefore of great importance to dissect the genetic determinants and molecular mechanisms responsible for diabetic cardiovascular complications. New research is of particular importance since, somewhat unexpectedly, large-scale clinical trials have indicated that glycemic control does not appear to have the anticipated major influence as a factor dictating cardiovascular outcome in diabetics. Hence, additional pathophysiological factors such as dyslipidemia, as well as proinflammatory and proatherosclerotic mechanisms, need to be more carefully examined. In this article, we will focus on recent studies in both animal models and humans as well as cellular mechanistic studies that advance our knowledge on the role of dyslipidemia, inflammation and atherosclerotic events in the cardiovascular complications of diabetes. We also translate our focus on research insights to related therapeutic opportunities.

Keywords::

• atherosclerosis
• cardiovascular complications
• diabetes
• dyslipidemia
• inflammation
• insulin resistance

Acknowledgements

The authors thank Sejin Yang for graphics assistance in figure preparation. There is a large body of outstanding literature that regrettably could not be cited here due to space restrictions.

Financial & competing interests disclosure

Work in the authors’ laboratories is funded by operating grants from the Canadian Institutes of Health Research (André Marette and Gary Sweeney), Canadian Diabetes Association (André Marette and Gary Sweeney), Heart & Stroke Foundation of Canada (Gary Sweeney) and the Korean Ministry of Education Science & Technology (Gary Sweeney). André Marette is the holder of a Pfizer/CIHR Chair on the pathogenesis of insulin resistance and cardiovascular disease. André Marette and Gary Sweeney are members of CIHR funded Cardiovascular Complications of Diabetes Team Grant. No conflict of interest is declared. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.