Microvascular Consequences of Obesity and Diabetes

Research output: Chapter in Book/Report/Conference proceedingChapter

Abstract

This chapter examines the unique problems and alterations of the diverse forms of vascular regulation caused by obesity, insufficient insulin, and insulin resistance. Much of the chapter focuses on changes in microvascular regulation in obesity as a prelude to the more serious consequences of insulin-independent diabetes in the obese animal and human. The issues of insulin resistance of obesity and eventual development of hyperglycemia despite very high circulating concentrations of insulin appear to synergistically interact to compromise both microvascular and macrovascular functions. Medical intervention with pharmacology, diet, and exercise allows the vast majority of persons with Types I and II diabetes with even modestly successful treatment to have very few bouts of severe hyperglycemia. Although there are similarities in the final macro- and microvascular outcomes of both Type I (insulin-deficient) and Type II (insulin-resistant) diabetes mellitus, the vast majority of Type I diabetes occurs in juvenile life while the body is growing. This raises an interesting possibility that disturbances of microvascular growth could impact both the juvenile vasculature and type of microvascular morphology present once the juvenile reaches adult life. Despite intervention, microvascular disease leading to impaired renal function, blindness, and skin damage and accelerated atherosclerosis of the macrovessels associated with stroke and myocardial infarction continue to be major issues for the Type I diabetic population. Probable mechanisms of impaired endothelial and vascular smooth muscle function due to inadequate insulin action and hyperglycemia are discussed.

Original languageEnglish (US)
Title of host publicationMicrocirculation
PublisherElsevier Inc.
Pages896-930
Number of pages35
ISBN (Print)9780123745309
DOIs
StatePublished - Dec 1 2008

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ASJC Scopus subject areas

  • Physiology
  • Molecular Biology
  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

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