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Diabetic Complications: An Update on Pathobiology and Therapeutic Strategies

Author(s):

Karthika Nellaiappan, Preeti Kumari, Dharmendra Kumar Khatri and Shashi Bala Singh*  

Abstract:


Despite the advent of novel therapies which manage and control diabetes well, the increased risk of morbidity and mortality in diabetic subjects is associated with the devastating secondary complications it produces. Long-standing diabetes majorly drives the cellular and molecular alterations which eventually damage both small and large blood vessels. The complications are prevalent both in type I and type II diabetic subjects. The microvascular complications include diabetic neuropathy, diabetic nephropathy, diabetic retinopathy, while the macrovascular complications include diabetic heart disease and stroke. The current therapeutic strategy alleviates the complications to some extent but do not cure or prevent them perse, also the recent clinical trial outcomes in this field is disappointing. Success in the drug discovery of diabetic complications may be achieved by a better understanding of the underlying pathophysiology and in recognising the crucial factors contributing to the development and progression of the disease. In this review, we discuss the well-studied cellular mechanisms leading to the development and progression of diabetic complications. In addition, we also highlight the various therapeutic paradigms currently in clinical practice.

Keywords:

Diabetes, Diabetic neuropathy, Diabetic kidney disease, Diabetic retinopathy, Diabetic heart disease, Pathophysiology, Drug-discovery

Affiliation:

Department of Pharmacology and Toxicology, National Institute of Pharmaceutical Education and Research (NIPER)-Hyderabad, Telangana-500037, Department of Pharmacology and Toxicology, National Institute of Pharmaceutical Education and Research (NIPER)-Hyderabad, Telangana-500037, Department of Pharmacology and Toxicology, National Institute of Pharmaceutical Education and Research (NIPER)-Hyderabad, Telangana-500037, Department of Pharmacology and Toxicology, National Institute of Pharmaceutical Education and Research (NIPER)-Hyderabad, Telangana-500037



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