Effect of blood glucose concentrations on the development of chronic complications of diabetes mellitus.

Diabetes is associated with increased risk of cardiovascular disease, coronary heart disease, stroke, acute myocardial infarction, blindness, and renal failure. Strategies to reduce their occurrence are an essential focus of patient care. More than one pathogenic process is involved, and genetics influence the risk. Hyperglycemia is a factor in the development of microvascular and possibly macrovascular complications. Two possible mechanisms of glucose damage are glycation of proteins and the polyol pathway. Research led to the identification of drugs that block parts of the pathways. In clinical trials, intensive control of blood glucose concentrations decreased the risk of microvascular complications. Adverse effects associated with intensive therapy, however, include hypoglycemia and weight gain.