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The Role of Biofactors in Diabetic Microvascular Complications

Author(s):

Dan Ziegler*, Massimo Porta, Nikolaos Papanas, Maria Mota, György Jermendy, Elena Beltramo, Aurora Mazzeo, Andrea Caccioppo, Elio Striglia, Victoria Serhiyenko, Alexandr Serhiyenko, László Rosta, Ovidiu Alin Stirban, Zsuzsanna Putz, Ildikó Istenes, Viktor Horváth and Peter Kempler  

Abstract:


Microvascular complications are responsible for a major proportion of the burden associated with diabetes contributing to substantial morbidity, mortality, and healthcare costs in people with diabetes. Retinopathy, nephropathy, and neuropathy constitute the leading causes of blindness, end-stage renal disease, and lower-extremity amputations, respectively. Since the efficacy of causal therapies of diabetic microvascular complications is limited, especially in type 2 diabetes, there is an unmet need for adjunct treatments which should be effective despite ongoing hyperglycemia. Experimental studies indicate that diabetic microvascular complications can be prevented or ameliorated by various biofactors in animal models by interfering with the pathophysiology of the underlying condition. Some of the findings related to biofactors like α-lipoic acid and benfotiamine could be translated into the clinical arena and confirmed in clinical trials, especially in those focusing on diabetic polyneuropathy. Given the micronutrient nature of these compounds, their safety profile is excellent. Thus, they have the potential to favorably modify the natural history of the underlying complication, but large long-term clinical trials are required to confirm this notion. Ultimately, biofactors should expand our therapeutic armamentarium against these common, debilitating, and even life-threatening sequelae of diabetes.

Keywords:

biofactors, diabetic microvascular complications, diabetic sensorimotor polyneuropathy, cardiovascular autonomic neuropathy, diabetic retinopathy, diabetic nephropathy

Affiliation:

Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University; Division of Endocrinology and Diabetology, Medical Faculty, Heinrich Heine University, Düsseldorf, Department of Medical Sciences, University of Turin, Turin, Diabetes Centre-Diabetic Foot Clinic, Second Department of Internal Medicine, Democritus University of Thrace, Alexandroupolis, Department of Diabetes, Nutrition and Metabolic Diseases, University of Medicine and Pharmacy Craiova, Third Department of Internal Medicine, Bajcsy-Zsilinszky Hospital, Budapest, Department of Medical Sciences, University of Turin, Turin, Department of Medical Sciences, University of Turin, Turin, Department of Medical Sciences, University of Turin, Turin, Department of Medical Sciences, University of Turin, Turin, Department of Endocrinology, Danylo Halytsky Lviv National Medical University, Lviv, Department of Endocrinology, Danylo Halytsky Lviv National Medical University, Lviv, Primary Healthcare Centre, Felsőrajk, Internistische Fachklinik Dr. Steger, Nürnberg, Semmelweis University, Department of Medicine and Oncology, Budapest, Semmelweis University, Department of Medicine and Oncology, Budapest, Semmelweis University, Department of Medicine and Oncology, Budapest, Semmelweis University, Department of Medicine and Oncology, Budapest



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