Diabetes and vascular disease: From pathogenesis to treatment: Are vascular effects of hypoglycemic and hypolipidemic drugs independent of their metabolic effects?

SummaryAngiopathy worsens the prognosis of diabetic patients. Its attenuation or prevention is one of the main goals of treatment. Advanced oxidative stress generated by hyperglycemia and in many diabetic patients also by dyslipidemia accelerates endothelial dysfunction as the first step in development of angiopathy. Improvement of diabetes control and dyslipidemia may have beneficial effect on oxidative stress as well as on other pathogenic factors. However, some hypoglycemic and hypolipidemic drugs may influence oxidative stress and endothelial dysfunction independently of their blood glucose-lowering or lipid-lowering effects. This review summarizes current knowledge on pathogenic mechanisms involved in development of diabetic angiopathies as well as new data on direct effects of selected hypoglycemic and lipid-lowering agents on oxidative stress and endothelium. This specific action influencing pathogenesis of vascular changes may therefore strengthen their beneficial effects in diabetic patients and in patients with metabolic syndrome as well.