Pathogenesis of Cardiovascular Disease in Diabetes

Endocrinol Metab Clin North Am. 2018 Mar;47(1):51-63. doi: 10.1016/j.ecl.2017.10.010.


The most common cause of death among adults with diabetes is cardiovascular disease (CVD). In this concise review on pathogenesis of CVD in diabetes, the 4 common conditions, atherosclerosis, microangiopathy, diabetic cardiomyopathy, and cardiac autonomic neuropathy, are explored and illustrated to be caused by interrelated pathogenetic factors. Each of these diagnoses can present alone or, commonly, along with others due to overlapping pathophysiology. Although the spectrum of physiologic abnormalities that characterize the diabetes milieu is broad and go beyond hyperglycemia, the authors highlight the most relevant evidence supporting the current knowledge of potent factors that contribute to CVD in diabetes.

Keywords: Cardiac autonomic neuropathy; Coronary flow reserve; Diabetic cardiomyopathy; Diabetic heart disease; Microangiopathy.

Publication types

  • Review

MeSH terms

  • Atherosclerosis / etiology*
  • Atherosclerosis / metabolism
  • Cardiac Conduction System Disease / etiology*
  • Cardiac Conduction System Disease / metabolism
  • Diabetes Mellitus, Type 1 / complications*
  • Diabetes Mellitus, Type 1 / metabolism
  • Diabetes Mellitus, Type 2 / complications*
  • Diabetes Mellitus, Type 2 / metabolism
  • Diabetic Angiopathies / etiology*
  • Diabetic Angiopathies / metabolism
  • Diabetic Cardiomyopathies / etiology*
  • Diabetic Cardiomyopathies / metabolism
  • Diabetic Neuropathies / etiology*
  • Diabetic Neuropathies / metabolism
  • Humans