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The Vasculature in Prediabetes.
Wasserman DH, Wang TJ, Brown NJ
Submitted Externally on 4/24/2018
Volume : Pages
122 : 1135 - 1150
The frequency of prediabetes is increasing as the prevalence of obesity rises
worldwide. In prediabetes, hyperglycemia, insulin resistance, and inflammation
and metabolic derangements associated with concomitant obesity cause endothelial
vasodilator and fibrinolytic dysfunction, leading to increased risk of
cardiovascular and renal disease. Importantly, the microvasculature affects
insulin sensitivity by affecting the delivery of insulin and glucose to skeletal
muscle; thus, endothelial dysfunction and extracellular matrix remodeling
promote the progression from prediabetes to diabetes mellitus. Weight loss is
the mainstay of treatment in prediabetes, but therapies that improved
endothelial function and vasodilation may not only prevent cardiovascular
disease but also slow progression to diabetes mellitus.
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