Chapter, 2024

Pathogenesis of Microvascular Complications

Textbook of Diabetes 9781119697473, Pages 613-628

Editors: Allan Flyvbjerg; Richard I.G. Holt

Publisher: Wiley

DOI: 10.1002/9781119697473.ch42


Flyvbjerg, Allan [1] [2]


  1. [1] Steno Diabetes Center
  2. [NORA names: Steno Diabetes Centers; Hospital; Denmark; Europe, EU; Nordic; OECD];
  3. [2] University of Copenhagen
  4. [NORA names: KU University of Copenhagen; University; Denmark; Europe, EU; Nordic; OECD]


Diabetic angiopathy is characterized by functional and structural organ damage as a result of changes in the vascular system. Late diabetesā€related complications may occur both in type 1 diabetes and type 2 diabetes, which is the reason all individuals with diabetes should be examined regularly in an appropriate screening programme. Microvascular complications are quantitatively dominant in type 1 diabetes, whereas macroangiopathy dominates the clinical appearance in type 2 diabetes. In the treatment priorities in the prevention of diabetic angiopathy, microvascular complications are best avoided by strict metabolic management of blood glucose, whereas macrovascular complications are best avoided by strict treatment of dyslipidaemia, hypertension, and other risk factors for cardiovascular disease. This chapter describes the pathogenesis of microvascular complications. A classical morphological feature of diabetesā€related microvascular complications (i.e. microangiopathy) is a thickening of the basement membrane in the capillaries and arterioles in the retina, kidney, and nerves.


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