Diabetes mellitus : endothelial dysfunction and changes in hemostasis

Diabetes mellitus involves a group of chronic metabolic disorders with elevated blood glucose concentrations. Since this disease needs lifelong treatment and care, the medical and social aspects present major public health concerns and pose a global challenge for health care providers. The number of aged patients with degenerative diseases undergoing surgical procedures is continuously increasing, resulting in an overwhelming dominance of diabetes in the perioperative care. There is a particular need for an increased awareness of diabetic patients in cardiovascular units, where the incidence of this disease reaches as high as 30-40%. The main hallmarks of the pathologic metabolic milieu of diabetes are hyperglycaemia, insulin resistance and pathologic lipid metabolism. The biochemical, cellular and organ-level pathophysiological changes lead to endothelial dysfunction including a low-grade prothrombotic balance, inflammatory state and, as a consequence, impaired micro- and macrocirculation. Diabetes is also followed by platelet dysfunction resulting from intracellular hyperglycaemia, because thrombocytes have insulin-independent glucose transporters in their cell membrane. The levels of the coagulation factors of the plasma are increased, and these factors are also modified by oxidation and glycation. Diabetes mellitus is a prothrombotic condition resulting from direct and indirect tendencies of the endothelial platelet and the plasma coagulation factors. The basic "bench to clinical basics" knowledge of the endothelial dysfunction and prothrombotic balance in diabetes may contribute to the better understanding of the clinical focuses in the perioperative care of patients with diabetes mellitus. Orv Hetil. 2018; 159(33): 1335-1345.

Medienart:

E-Artikel

Erscheinungsjahr:

2018

Erschienen:

2018

Enthalten in:

Zur Gesamtaufnahme - volume:159

Enthalten in:

Orvosi hetilap - 159(2018), 33 vom: 07. Aug., Seite 1335-1345

Sprache:

Ungarisch

Weiterer Titel:

Diabetes mellitus: endotheldiszfunkció és haemostasiselváltozások

Beteiligte Personen:

Babik, Barna [VerfasserIn]
Peták, Ferenc [VerfasserIn]
Agócs, Szilvia [VerfasserIn]
Blaskovics, Ivett [VerfasserIn]
Alács, Endre [VerfasserIn]
Bodó, Kinga [VerfasserIn]
Südy, Roberta [VerfasserIn]

Links:

Volltext

Themen:

Changes in endothelial function
Cukorbetegség
Endothelkárosodás
Hemostasis imbalance
Journal Article
Review
Type 2 diabetes
Véralvadás-egyensúlyeltolódás

Anmerkungen:

Date Completed 02.10.2018

Date Revised 04.10.2018

published: Print

Citation Status MEDLINE

doi:

10.1556/650.2018.31130

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM287389138