Microvascular Disease in Diabetes

Presents comprehensive coverage of the many microvascular complications of diabetes
 
Diabetes remains one of the main causes, in the western world, of legal blindness, end stage renal disease, and amputation, despite the implementation of tight glycemic control and the great progress in the management and care of our patients. This book provides a useful and handy tool to professionals and students in the field of diabetes and its microvascular complications by integrating information from clinical settings as well as from the frontlines of diabetic research. It provides readers with up-to-date diagnostic criteria, classifications, and therapeutic approaches. and recent discoveries on mechanisms of disease, experimental therapeutic agents, and biomarkers of disease.
 
Written by top experts in the field, Microvascular Disease in Diabetes offers in-depth chapters covering pathophysiology; the genetics of diabetic microvascular disease; and the epigenetics of diabetic microvascular disease. It then provides sections featuring both clinical and research information on diabetic retinopathy, diabetic nephropathy, diabetic neuropathy, and diabetic foot. It also looks at coronary microvascular dysfunction and cerebral microvascular disease.
* Integrates new and accessible material on diabetic microvascular comorbidities
* Covers all relevant microvascular systems
* Provides a much-needed resource synthesizing research and clinical applications to treating microvascular complications of diabetes
* Presents current diagnostic criteria, classifications, and therapeutic approaches, as well as recent discoveries on the mechanisms of disease, experimental therapeutic agents, and biomarkers of disease
 
Assembled in an easily consultable manner, Microvascular Disease in Diabetes is an excellent text for investigators, clinicians, and students looking to improve their understanding of diabetic complications.

List of contents

Foreword to: Microvascular Disease in Diabetes xv
 
Editor Biography xvii
 
List of Contributors xix
 
1 Introduction 1
Andrea Giustina and Stefano Frara
 
References 3
 
2 Pathophysiology 5
Francesco Tecilazich
 
Introduction 5
 
Anatomo-Physiology of Microvessels 5
 
Regulation of Microvascular Tone 6
 
Endothelial-Dependent Vasodilation 6
 
Endothelial-Independent Vasodilation 6
 
Nerve Axon Reflex (NARV) 7
 
Myogenic Response 7
 
Functional Hyperemia 7
 
Venoarteriolar Response (VAR) 8
 
Structural Changes in the Microcirculation 8
 
Functional Changes in the Microcirculation 8
 
Endothelial Dysfunction 8
 
VSMC Dysfunction 9
 
NARV Impairment 9
 
Defective Myogenic Response 10
 
Reduced Functional Hyperemia 10
 
Endothelial Dysfunction 11
 
Role of the Immune System and Leukostasis 11
 
Role of Hyperglycemia 12
 
AGEs 12
 
Polyol Pathway 12
 
Oxidative Stress 13
 
PKC 13
 
Transforming Growth Factor (TGF)-ß 14
 
Hexosamine Pathway 14
 
PARP 14
 
ET-1 14
 
Vasoconstrictor Prostanoid Synthesis 15
 
Role of Insulin Resistance 15
 
Role of Inflammation 15
 
References 16
 
3 Genetics of Diabetic Microvascular Disease 23
Niina Sandholm and Carol Forsblom
 
Introduction 23
 
Genetics of DKD 23
 
Heritability of DKD 23
 
Candidate Genes for DKD 24
 
Linkage Studies for DKD 25
 
Genome-Wide Association Studies on DKD 25
 
Sequencing Efforts for DKD 29
 
Genetics of Diabetic Retinopathy 30
 
Heritability of Diabetic Retinopathy 30
 
Candidate Genes for Diabetic Retinopathy 30
 
Linkage Studies for Diabetic Retinopathy 31
 
GWAS on Diabetic Retinopathy 31
 
Sequencing Efforts for Diabetic Retinopathy 33
 
Genetics of Diabetic Neuropathy 33
 
Heritability of Diabetic Neuropathy 33
 
Candidate Genes for Diabetic Neuropathy 33
 
GWASs on Diabetic Neuropathy 34
 
Future Directions 34
 
Larger Studies are Needed 34
 
How to Define the Phenotype? 35
 
Variability in the Phenotypic Definitions 35
 
Criteria for Controls 36
 
Do Genetics of Microvascular Complications in T1D and T2D Differ? 36
 
Low-Frequency and Rare Variants May Affect Diabetic Complications 36
 
Sequencing of Rare and Low-Frequency Variants 36
 
Linkage Analysis with GWAS Data 37
 
Genetics May Reveal Biology and Infer Causality 37
 
Conclusions 37
 
References 37
 
4 Epigenetics of Diabetic Microvascular Disease 45
Luciano Pirola
 
Diabetic Complications Include Microvascular and Macrovascular Injury 45
 
The Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications (DCCT/EDIC) Study in Type 1 Diabetic Patients, and the UKPDS Study in Type 2 Diabetic Patients, Support the Existence of the Hyperglycemic Memory Phenomenon 46
 
DCCT/EDIC Study 46
 
The UKPDS Study 46
 
Models of Hyperglycemic Memory 47
 
Animal Models 47
 
Cell Culture Models 48
 
The "Epigenetic Code" 48
 
DNA Methylation 49
 
Histone Methylation in Models of Hyperglycemic Variability 49
 
Epigenetic Changes in Microvascular Models of Glycemic Memory 50
 
MiRNAs Contribute to the Control of Glucose Homeostasis and are Dysregulated in Diabetes 52
 
Future Prospects 52
 
References

About the author

FRANCESCO TECILAZICH, MD, PhD, is a physician and scientist in the Endocrinology and Metabolic Diseases department of the Ospedale San Raffaele?Vita Salute San Raffaele University in Milan, Italy.

Summary

Presents comprehensive coverage of the many microvascular complications of diabetes

Diabetes remains one of the main causes, in the western world, of legal blindness, end stage renal disease, and amputation, despite the implementation of tight glycemic control and the great progress in the management and care of our patients. This book provides a useful and handy tool to professionals and students in the field of diabetes and its microvascular complications by integrating information from clinical settings as well as from the frontlines of diabetic research. It provides readers with up-to-date diagnostic criteria, classifications, and therapeutic approaches. and recent discoveries on mechanisms of disease, experimental therapeutic agents, and biomarkers of disease.

Written by top experts in the field, Microvascular Disease in Diabetes offers in-depth chapters covering pathophysiology; the genetics of diabetic microvascular disease; and the epigenetics of diabetic microvascular disease. It then provides sections featuring both clinical and research information on diabetic retinopathy, diabetic nephropathy, diabetic neuropathy, and diabetic foot. It also looks at coronary microvascular dysfunction and cerebral microvascular disease.
* Integrates new and accessible material on diabetic microvascular comorbidities
* Covers all relevant microvascular systems
* Provides a much-needed resource synthesizing research and clinical applications to treating microvascular complications of diabetes
* Presents current diagnostic criteria, classifications, and therapeutic approaches, as well as recent discoveries on the mechanisms of disease, experimental therapeutic agents, and biomarkers of disease

Assembled in an easily consultable manner, Microvascular Disease in Diabetes is an excellent text for investigators, clinicians, and students looking to improve their understanding of diabetic complications.

Product details

• Authors: F Tecilazich, Francesco Tecilazich
• Assisted by: Francesc Tecilazich (Editor), Francesco Tecilazich (Editor)
• Publisher: Wiley, John and Sons Ltd
• Languages: English
• Product format: Hardback
• Released: 31.12.2019
• EAN: 9781119309604
• ISBN: 978-1-119-30960-4
• No. of pages: 280
• Subjects: Guides; Natural sciences, medicine, IT, technology > Medicine; Diabetes, Medizin, Medical Genetics, Medical Science, Invasive Kardiologie, Interventional Cardiology, Medizinische Genetik