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Diabetologia. 2019 Sep;62(9):1539-1549. doi: 10.1007/s00125-019-4959-1. Epub 2019 Jul 25.

New insights into the mechanisms of diabetic complications: role of lipids and lipid metabolism.

Author information

1
Department of Neurology, University of Michigan, Ann Arbor, MI, USA.
2
Division of Nephrology, Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA.
3
Department of Ophthalmology and Visual Sciences, University of Michigan Kellogg Eye Center, 1000 Wall Street, Ann Arbor, MI, 48105, USA.
4
Department of Molecular and Integrative Physiology, University of Michigan, Ann Arbor, MI, USA.
5
Department of Ophthalmology and Visual Sciences, University of Michigan Kellogg Eye Center, 1000 Wall Street, Ann Arbor, MI, 48105, USA. patricef@med.umich.edu.
6
Department of Molecular and Integrative Physiology, University of Michigan, Ann Arbor, MI, USA. patricef@med.umich.edu.

Abstract

Diabetes adversely affects multiple organs, including the kidney, eye and nerve, leading to diabetic kidney disease, diabetic retinopathy and diabetic neuropathy, respectively. In both type 1 and type 2 diabetes, tissue damage is organ specific and is secondary to a combination of multiple metabolic insults. Hyperglycaemia, dyslipidaemia and hypertension combine with the duration and type of diabetes to define the distinct pathophysiology underlying diabetic kidney disease, diabetic retinopathy and diabetic neuropathy. Only recently have the commonalities and differences in the metabolic basis of these tissue-specific complications, particularly those involving local and systemic lipids, been systematically examined. This review focuses on recent progress made using preclinical models and human-based approaches towards understanding how bioenergetics and metabolomic profiles contribute to diabetic kidney disease, diabetic retinopathy and diabetic neuropathy. This new understanding of the biology of complication-prone tissues highlights the need for organ-specific interventions in the treatment of diabetic complications.

KEYWORDS:

Diabetes; Diabetic complications; Lipid metabolism; Omics; Review; Specific mechanisms

PMID:
31346658
PMCID:
PMC6679814
[Available on 2020-09-01]
DOI:
10.1007/s00125-019-4959-1

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