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There are also secondary complications of diabetes (cardiomyopathy, erectile dysfunction or diabetic foot ulcers). Stem cell\u2010based therapies have become a promising tool targeting diabetes symptoms and its chronic complications. Among all stem cells, adipose\u2010derived mesenchymal stem cells (ADMSCs) are of great importance because of their abundance, non\u2010invasive isolation and no ethical limitations. Characteristics that make ADMSCs good candidates for cell\u2010based therapy are their wide immunomodulatory properties and paracrine activities through the secretion of an array of growth factors, chemokines, cytokines, angiogenic factors and anti\u2010apoptotic molecules. Besides, after transplantation, ADMSCs show great ex vivo expansion capacity and differentiation to other cell types, including insulin\u2010producing cells, cardiomyocytes, chondrocytes, hepatocyte\u2010like cells, neurons, endothelial cells, photoreceptor\u2010like cells, or astrocytes. Preclinical studies have shown that ADMSC\u2010based therapy effectively improved visual acuity, ameliorated polyneuropathy and foot ulceration, arrested the development and progression of diabetic kidney disease, or alleviated the diabetes\u2010induced cardiomyocyte hypertrophy. However, despite the positive results obtained in animal models, there are still several challenges that need to be overcome before the results of preclinical studies can be translated into clinical applications. To date, there are several clinical trials or ongoing trials using ADMSCs in the treatment of diabetic complications, most of them in the treatment of diabetic foot ulcers. This narrative review summarizes the most recent outcomes on the usage of ADMSCs in the treatment of long\u2010term complications of diabetes in both animal models and clinical trials.<\/jats:p>","DOI":"10.1111\/dom.15375","type":"journal-article","created":{"date-parts":[[2023,12,11]],"date-time":"2023-12-11T03:35:22Z","timestamp":1702265722000},"page":"793-808","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["Efficacy of adipose\u2010derived mesenchymal stem cell therapy in the treatment of chronic micro\u2010 and macrovascular complications of diabetes"],"prefix":"10.1111","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4936-3120","authenticated-orcid":false,"given":"Agnieszka","family":"Mik\u0142osz","sequence":"first","affiliation":[{"name":"Department of Physiology Medical University of Bialystok  Bialystok Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adrian","family":"Chabowski","sequence":"additional","affiliation":[{"name":"Department of Physiology Medical University of Bialystok  Bialystok Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,12,11]]},"reference":[{"key":"e_1_2_12_2_1","unstructured":"International Diabetes FederationAvailable online:https:\/\/diabetesatlas.org\/data\/en\/indicators\/7\/. 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