The molecular basis of diabetic microangiopathy.

Diabetes mellitus is a chronic disease characterized by hyperglycaemia and carbohydrate, fat and protein metabolism abnormalities, all due to an impairment in insulin homeostasis and a diffuse microangiopathy most involving retina, kidney and nerves. Several mechanisms are altered at a molecular level and interplay to develop the slow but devastating clinical impairments related to microangiopathy. Polyol pathway, advanced glycation endproducts, protein kinase C, hexosamine pathway and oxidative stress are among those mechanisms. Molecular pathways of diabetes from hyperglycaemia to signalling cascades alterations and the most promising strategies for successful therapeutic approaches derived from better knowledge of biochemical mechanisms are treated extensively in the present review.