Vnitr Lek 2024, 70(6):E3-E9 | DOI: 10.36290/vnl.2024.079
Microvascular complications of diabetes - their prevention and treatment
- III. interní gerontometabolická klinika, Lékařská fakulta a Fakultní nemocnice Hradec Králové
Microvascular complications of diabetes are a cause of significant morbidity and cardiovascular mortality of patients with diabetes. Their development and progression is associated with chronic hyperglycemia, and other risk factors are hypertension, dyslipidemia, smoking and genetic factors. Preventative startegies should focus on optimal individualized glycemic control, and also treatment of other modifiable factors. Early detection of complications using screening procedures and early and appropriate treatment lower the risk of advanced complications and of their subsequent physical, social and economic impact.
Keywords: diabetic retinopathy, hyperglycemia, nephropathy, neuropathy, prevention.
Accepted: September 19, 2024; Published: October 3, 2024 Show citation
References
- Saeedi P, Petersohn I, Salpea P, et al. Global and regional diabetes prevalence estimates for 2019 and projections for 2030 and 2045: Results form the International Diabetes Federation Diabetes Atlas, 9th edition. Diabete Res Clin Pract. 2019;157:107843.
Go to original source...
- Harding JL, Pavkov ME, Magliano DJ et al. Global trends in diabetes complications: a review of current evidence. Diabetologia. 2019;62:(1):3-16.
Go to original source...
Go to PubMed...
- Pearce I, Simó R, Lövestam-Adrian M, et al. Association between diabetic eye disease and other complications of diabetes: Implications for care. A systematic review. Diabetes Obes Metab. 2019; 21(3):467-478.
Go to original source...
Go to PubMed...
- Lin YC, Chang YH, Yang SY, et al. Update of pathophysiology and management of diabetic kidney disease. J Formos Med Assoc. 2018; 117(8):662-675.
Go to original source...
Go to PubMed...
- American Diabetes Association. 12. Retinopathy, Neuropathy, and Foot Care: Standards of Care in Diabetes - 2024. Diabetes Care. 2024;47(Suppl 1):S231-243.
Go to original source...
Go to PubMed...
- Zhelev Z, Peters J, Rogers M, et al. Test accuracy of artificial intelligence-based grading of fundus images in diabetic retinopathy screening: A systematic review. J Med Screen. 2023;30(3):97-112.
Go to original source...
Go to PubMed...
- Pelikánová T, Bartoš V, et al. Praktická diabetologie. 6. vydání. Praha: Maxdorf Jessenius, 2018. ISBN 978-80-7345-559-0.
- Bain SC, Klufas MA, Ho A, et. al. Worsening of diabetic retinopathy with rapid improvement in systemic glucose control: A review. Diabetes Obes Metasb. 2019;21:454.
Go to original source...
Go to PubMed...
- UKPDS Study Group. Tight blood pressure control and risk of macrovascular and microvascular complications in type 2 diabetes (UKPDS 38). BMJ 1998;317:703-13.
Go to original source...
- American Diabetes Association Professional Practice Committee. 10. Cardiovascular Disease and Risk Management: Standards of Care in Diabetes - 2024. Diabetes Care. 2024; 47:S179.
Go to original source...
Go to PubMed...
- Chung YR, Park SW, Choi SY, et al. Association of statin use and hypertriglyceridemia with diabetic macular edema in patients with type 2 diabetes and diabetic retinopathy. Cardiovasc Diabetol. 2017;16:4.
Go to original source...
Go to PubMed...
- Keech AC, Mitchell P, Summamen PA, et al. Effect of fenofibrate on the need for laser treatment for diabetic retinopathy (FIELD study): a randomised controlled trial. Lancet 2007;370:1687.
Go to original source...
Go to PubMed...
- ACCORD Study Group, ACCORD Eye Study Group, Chew EY, at al. Effects of medical therapies on retinopathy progression in type 2 diabetes. N Engl J Med. 2010; 363:233.
Go to original source...
Go to PubMed...
- Altaf QA, Dodson P, Ali A, at al. Obstructive sleep apnea and retinopathy in patients with type 2 diabetes. A longitudinal study. Am J Respir Crit Care Med. 2017;196:892-900.
Go to original source...
Go to PubMed...
- Widyaputri F, Rogers SL, Kandasamy R et al. Global estimates of diabetic retinopathy prevalence and progression in pregnat women with preexisting diabetes: a systematic review and meta-analysis. JAMA Ophthalmol. 2022;140:486-494.
Go to original source...
Go to PubMed...
- de Boer IH; DCCT/EDIC Research Group. Kidney disease and related findings in the Diabetes Control and Complications Tria/Epidemiology of Diabetes Interventions and Complications study. Diabetes Care. 2014;37:24. 30.
Go to original source...
Go to PubMed...
- Bikbov B, Purcell CA, Levey AS, et al. Global, regional, and national burden of chronic kidney disease, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet. 2020;395(10225):709-733.
Go to original source...
Go to PubMed...
- Fox CS, Matsushita K, Woodward M, et al. Chronic Kidney Disease Prognosis Consortium, Associations of kidney disease measures with mortality and end-stage renal disease in individuals with and without diabetes: a meta-analysis. Lancet 2012;380:1662-1673.
Go to original source...
Go to PubMed...
- Alicic RZ, Rooney MT, Tuttle KR. Diabetic Kidney disease: Challenges, progress and possibilities.Clin J Am Soc Nephrol. 2017;12(12)2032-2045.
Go to original source...
Go to PubMed...
- National Kidney Foundation: KDOQI clinical practice guideline for diabetes and CKD: 2012 update. Am J Kidney Dis. 60:850-886.
Go to original source...
Go to PubMed...
- Pelikánová T, Viklický O, Rychlík I, et al. Doporučené postupy při diabetickém onemocnění ledvin 2021.
- DCCT/EDIC research group. Efect of intensive diabetes treatment on albuminuria in type 1 diabetes: long-term follow-up of the Diabetes Control and Complications Trial and Epidemiology of Diabetes Interventions and Complications study. Lancet Diabetes Endocrinol. 2014;2:793-800.
Go to original source...
Go to PubMed...
- UK Prospective Diabetes Study. (UKPDS) Group. Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). Lancet. 1998;352:837.
Go to original source...
- Papademitrou V, Lovato L, Doumas M, et al. ACCORD Study Group. Chronic kidney disease and intensive glycemic control increase cardiovascular risk in patients with type 2 diabetes. Kidney Int. 2015;87:649-659.
Go to original source...
Go to PubMed...
- de Boer IH, Bangalore S, Benetos A, et al. Diabetes and hypertension: a position statement by the American Diabetes Association. Diabetes Care. 2017;40:1273-1284.
Go to original source...
Go to PubMed...
- Brenner BM, Cooper ME, de Zeeuw D, et al. RENAAL Study Investigators. Effects of losartan on renal and cardiovascular outcomes in patients with type 2 diabetes and nephropathy. N Engl J Med. 2001;345:861-869.
Go to original source...
Go to PubMed...
- American Diabetes Association. 11. Chronic kidney disease and risk management: Standards of Care in Diabetes - 2024. Diabetes Care. 2024;47(Suppl 1):S219-230.
Go to original source...
Go to PubMed...
- Zelniker TA, Braunwald E. Cardiac and renal effects of sodium-glucose co-transporter 2 inhibitors in diabetes: JACC state-of-the-art review. J Am Col Cardiol. 2018;72:1845-1855.
Go to original source...
Go to PubMed...
- Yaribeygi H, Butler AE, Atkin SL, et al. Sodium-glucoce contransporter 2 inhibitors and inflammation in chronic kidney disease: possible molecular pathways. J Cell Physiol. 2018;234:223-230.
Go to original source...
Go to PubMed...
- Shaman AM, Bain SC, Bakris GL, et al. Effects of the glucagon-like peptide-1 receptor agonists semaglutide and liraglutide on kidney outcomes in patients with type 2 diabetes: pooled analysis of SUSTAIN 6 and LEADER. Circulation. 2022;145:575-585.
Go to original source...
Go to PubMed...
- McGuire DK, Shih WJ, Consentino F, et al. Association of SGLT2 inhibitors with cardiovascular and kidney outcomes in patients with type 2 diabetes: a meta-analysis. JAMA Cardiol. 2021;6:148-158.
Go to original source...
Go to PubMed...
- Zelniker TA, Wiwiot SD, Raz I, et al. Comparison of the effects of glucagon-like peptide receptor agonists and sodium-glucose cotransporter 2 inhibitors for prevention of major adverse cardiovascular and renal outcomes in type 2 diabetes mellitus. Circulation. 2019;139:2022-2031.
Go to original source...
Go to PubMed...
- Perkovic V., Tuttle KR, Rossing P, et al. Effects of semaglutide on chronic kidney disease in patients with type 2 diabetes. NEJM 2024;391:109-121.
Go to original source...
Go to PubMed...
- Agarwal R, Filippatos G, Pitt B, et al. FIDELIO-DKD and FIGARO-DKD investigators. Cardiovascular and kidney outcomes with finerenone in patients with type 2 diabetes and chronic kidney disease: the FIDELITY pooled analysis. Eur Heart J. 2022;43:474-484.
Go to original source...
- Liu X, Xu Y, An M, et al. The risk factors for diabetic peripheral neuropathy: A metaanalysis. PLoS One. 2019;14:e0212574.
Go to original source...
Go to PubMed...
- Lacigová S, Rušavý Z, Jirkovská A, Škrha J. Doporučený postup diagnostiky a léčby diabetické neuropatie (2016).
- Ang L, Jaiswal M, Martin C, et al. Glucose control and diabetic neuropathy: lessons from recent large clinical trials. Curr Diab Rep. 2014;14:528.
Go to original source...
Go to PubMed...
- Callaghan BC, Little AA, Feldman EL, et al. Enhanced glucose control for preventing and treating diabetic neuropathy. Cochrane Database Syst Rev. 2012;6:CD007543.
Go to original source...
Go to PubMed...
- ACCORD Study Group. Effect of intensive treatment of hyperglycemia on microvascular outcomes in type 2 diabetes: an analysis of ACCORD randomised trail. Lancet. 2010;376(9739):419-430.
Go to original source...
Go to PubMed...
- Jirkovská A., et al. Syndrom diabetické nohy - Prevence, diagnostika a terapie. Geum 2022. ISBN 978-80-87969-61-8.
- Baicus C, Purcarea A, von Elm E, et al. Alpha-lipoic acid for diabetic peripheral neuropathy. Cochrane Database Syst Rev. 2024;CD012967.
Go to original source...