Microangiopathy in diabetes mellitus: I. Causes, prevention and treatment.

Microangiopathy is the major cause of death in Insulin Dependent Diabetes Mellitus. However, the pathogenesis of microangiopathy is still far from clear. This paper is a review of the literature on diabetic microangiopathy and discusses the current theories concerning its causes, prevention and treatment. The roles of abnormal glucose metabolism, protein glycosylation, genetic factors and puberty as well as the changes in vascular endothelium, capillary permeability and blood constituents, in the development of microangiopathy are discussed. The benefits of strict control of blood glucose concentrations are discussed along with the action of various pharmaceutical preparations such as aldose reductase inhibitors, hydroxyrutosides, pentoxifylline and free radical scavengers currently assessed in the prevention or treatment of diabetic microangiopathy.