Épidémiologie et physiopathologie des complications dégénératives du diabète sucré

Abstract

Physiopathology of degenerative complications of diabetes involves metabolic, vascular and genetic factors which interact one with another. Chronic hyperglycemia is at origine of metabolic and vascular abnormalities. Metabolic factors are increased polyols pathway, glycation of proteins, abnormalities of essential fatty acids metabolism, increase of oxydative pathway, C-peptide deficiency and increase of growth factors production. The vascular factors are represented by the decrease of oxide nitric synthesis, and the increase of protein kinase C activity. The genetic factors concern particularly the nephropathy with an angiotensin conversion enzyme gene polymorphism, and neuropathy, with Na/K ATPase gene polymorphism, which could explain the protection or predisposition of patients to these complications.