Cerebral neovascularization in diabetes: implications for stroke recovery and beyond

J Cereb Blood Flow Metab. 2014 Apr;34(4):553-63. doi: 10.1038/jcbfm.2014.18. Epub 2014 Feb 5.


Neovascularization is an innate physiologic response by which tissues respond to various stimuli through collateral remodeling (arteriogenesis) and new vessel formation from existing vessels (angiogenesis) or from endothelial progenitor cells (vasculogenesis). Diabetes has a major impact on the neovascularization process but the response varies between different organ systems. While excessive angiogenesis complicates diabetic retinopathy, impaired neovascularization contributes to coronary and peripheral complications of diabetes. How diabetes influences cerebral neovascularization remained unresolved until recently. Diabetes is also a major risk factor for stroke and poor recovery after stroke. In this review, we discuss the impact of diabetes, stroke, and diabetic stroke on cerebral neovascularization, explore potential mechanisms involved in diabetes-mediated neovascularization as well as the effects of the diabetic milieu on poststroke neovascularization and recovery, and finally discuss the clinical implications of these effects.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, Non-P.H.S.
  • Review

MeSH terms

  • Animals
  • Cerebral Cortex / blood supply*
  • Clinical Trials as Topic
  • Diabetes Mellitus / drug therapy
  • Diabetes Mellitus / metabolism
  • Diabetes Mellitus / pathology*
  • Diabetes Mellitus / physiopathology
  • Humans
  • Hypoglycemic Agents / administration & dosage
  • Hypoglycemic Agents / therapeutic use
  • Neovascularization, Pathologic*
  • Neovascularization, Physiologic*
  • Oxidative Stress / drug effects
  • Recovery of Function
  • Stroke / complications
  • Stroke / metabolism
  • Stroke / pathology
  • Stroke / prevention & control*


  • Hypoglycemic Agents