ABSTRACT
Diabetes complications represents a major healthcare burden associated with the treatment of diabetes. Despite advances in new therapies for controlling hyperglycemia, the burden associated with diabetic complications remains high, especially in relation to cardiovascular and renal complications. It is a global burden due to the various evidence which shows it can develop to metabolic disorders when this group of disease is not properly managed. Although the duration of diabetes mellitus influences the development of complications, it is known that some patients are more susceptible to complications than others. Patients with diabetes have an approximately two- to fourfold increased risk of coronary heart diseases. Neuropathic pain is the most common chronic complication of diabetes mellitus. The mechanisms involved in the development of diabetic neuropathy include changes in the blood vessels that supply the peripheral nerves; metabolic disorders, such as the enhanced activation of the polyol pathway; myo-inositol depletion; and increased non-enzymatic glycation. The DAG-PKC pathway contributes to vascular function in many ways such as the regulation of endothelial permeability, vasoconstriction, extracellular matrix synthesis/turnover, cell growth, angiogenesis, cytokine activation, and leukocyte adhesion. Hyperglycemia has been shown to be the major risk factor responsible for the development and progression of microvascular complications of diabetes. The potential severity of increasing prevalence rate of diabetes in developing countries may be translated into severe economic burden, high morbidity and mortality rates that will surpass the ravages.
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