{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T13:30:37Z","timestamp":1780061437999,"version":"3.54.0"},"reference-count":197,"publisher":"Bentham Science Publishers Ltd.","issue":"29","content-domain":{"domain":["eurekaselect.com"],"crossmark-restriction":true},"short-container-title":["CPD"],"published-print":{"date-parts":[[2019,10,21]]},"abstract":"<jats:sec>\n<jats:title>Background:<\/jats:title>\n<jats:p> Diabetes is increasing over time, mainly driven by obesity, aging, and urbanization.\nClassical macro- and microvascular complications represent the final result of a complex interplay involving\natherosclerosis at all stages.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Methods:<\/jats:title>\n<jats:p> In this review, we aim at focusing on current updates in the pathophysiology of vascular disease in\ndiabetes and discussing how new therapies might influence the management of these patients at high cardiovascular\nrisk. Diabetes shows accelerated atherosclerosis with a larger inflammatory cell infiltrate, thus favoring the\ndevelopment of heart failure. \u2018Diabetic cardiomyopathy\u2019 perfectly describes a specific ischemia- and hypertension-\nindependent entity due to diabetes-related metabolic alterations on myocardial function. Moreover, platelets\nfrom subjects with diabetes display a typical hyperreactivity explaining the stronger adhesion, activation, and\naggregation. Additionally, diabetes provokes an exaggerated stimulation of the endothelium, with an increased\nrelease of reactive oxygen species and a reduced release of nitric oxide, both key elements of the endothelial\ndysfunction. Also, the coagulation cascade and leukocytes activate contributing to this pro-thrombotic environment.\nNeutrophils have been recently recognized to play a pivotal role by releasing neutrophil extracellular traps.\nFinally, microparticles from platelets, neutrophils or monocytes are detrimental effectors on the vessel wall and\nare involved both in vascular dysfunction and in thrombotic complications.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Conclusion:<\/jats:title>\n<jats:p> In light of these findings, the therapeutic management of diabetes needs to be mostly focused on\nlimiting the progression of complications by targeting precise pathophysiological mechanisms rather than the\nmere glycemic control, which failed to markedly reduce the risk for macrovascular complications and mortality.<\/jats:p>\n<\/jats:sec>","DOI":"10.2174\/1381612825666190830181944","type":"journal-article","created":{"date-parts":[[2019,8,31]],"date-time":"2019-08-31T00:05:41Z","timestamp":1567209941000},"page":"3112-3127","update-policy":"https:\/\/doi.org\/10.2174\/bsp_crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Diabetes and Vascular Disease: Is It All About Glycemia?"],"prefix":"10.2174","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0410-5996","authenticated-orcid":true,"given":"Alessandra","family":"Vecchi\u00e9","sequence":"first","affiliation":[{"name":"First Clinic of Internal Medicine, Department of Internal Medicine, University of Genoa, 6 viale Benedetto XV, 16132 Genoa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0823-8729","authenticated-orcid":true,"given":"Fabrizio","family":"Montecucco","sequence":"additional","affiliation":[{"name":"First Clinic of Internal Medicine, Department of Internal Medicine and Centre of Excellence for Biomedical Research (CEBR), University of Genoa, 6 Viale Benedetto XV, 16132 Genoa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2957-4078","authenticated-orcid":true,"given":"Federico","family":"Carbone","sequence":"additional","affiliation":[{"name":"First Clinic of Internal Medicine, Department of Internal Medicine, University of Genoa, 6 viale Benedetto XV, 16132 Genoa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9537-4547","authenticated-orcid":true,"given":"Franco","family":"Dallegri","sequence":"additional","affiliation":[{"name":"First Clinic of Internal Medicine, Department of Internal Medicine, University of Genoa, 6 viale Benedetto XV, 16132 Genoa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4747-5535","authenticated-orcid":true,"given":"Aldo","family":"Bonaventura","sequence":"additional","affiliation":[{"name":"First Clinic of Internal Medicine, Department of Internal Medicine, University of Genoa, 6 viale Benedetto XV, 16132 Genoa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"965","reference":[{"key":"ref=1","doi-asserted-by":"publisher","first-page":"56","DOI":"10.1016\/S2213-8587(13)70112-8","volume":"2","author":"Zimmet P.Z.","year":"2014","unstructured":"Zimmet P.Z.; Magliano D.J.; Herman W.H.; Shaw J.E.; Diabetes: a 21 century challenge. 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