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REVIEW article
Front. Med.
Sec. Pathology
Volume 12 - 2025 |
doi: 10.3389/fmed.2025.1509884
This article is part of the Research Topic Phenotypic Transitions and Endothelial Dysfunction in Cardiovascular Diseases: Mechanisms, Therapeutic Targets, and Modulation View all articles
Comprehensive treatment of diabetic endothelial dysfunction based on pathophysiological mechanism
Provisionally accepted- 1 Shanghai University of Traditional Chinese Medicine, Shanghai, Shanghai Municipality, China
- 2 Putuo Hospital, Shanghai University of Traditional Chinese Medicine, Putuo District Central Hospital, Shanghai, Shanghai Municipality, China
Vascular endothelium is integral to the regulation of vascular homeostasis and maintenance of normal arterial function in healthy individuals. Endothelial dysfunction is a significant contributor to the advancement of atherosclerosis, which can precipitate cardiovascular complications. A notable correlation exists between diabetes and endothelial dysfunction, wherein chronic hyperglycemia and acute fluctuations in glucose levels exacerbate oxidative stress. This results in diminished nitric oxide synthesis and heightened production of endothelin-1, ultimately leading to endothelial impairment. In clinical settings, it is imperative to implement appropriate therapeutic strategies aimed at enhancing endothelial function to prevent and manage diabetes-associated vascular complications. Various antidiabetic agents, including insulin, GLP-1 receptor agonists, sulfonylureas, DPP-4 inhibitors, SGLT2 inhibitors, 2 α-glucosidase inhibitors, thiazolidinediones (TZDs), and metformin, are effective in mitigating blood glucose variability and improving insulin sensitivity by lowering postprandial glucose levels. Additionally, traditional Chinese medicinal compounds, such as turmeric extract, resveratrol, matrine alkaloids, tanshinone, puerarin, tanshinol, paeonol, astragaloside, berberine, and quercetin, exhibit hypoglycemic properties and enhance vascular function through diverse mechanisms. Consequently, larger randomized controlled trials involving both pharmacological and herbal interventions are essential to elucidate their impact on endothelial dysfunction in patients withdiabetes. This article aims to explore a comprehensive approach to the treatment of diabetic endothelial dysfunction based on an understanding of its pathophysiology.
Keywords: Diabetes Mellitus, cardiovascular disease, endothelial dysfunction, Oxidative Stress, Insulin Resistance, Antidiabetic agents, Traditional Chinese Medicine
Received: 11 Oct 2024; Accepted: 24 Jan 2025.
Copyright: © 2025 Liu, Lu, Sha and Lei. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Wenjun Sha, Putuo Hospital, Shanghai University of Traditional Chinese Medicine, Putuo District Central Hospital, Shanghai, Shanghai Municipality, China
Tao Lei, Putuo Hospital, Shanghai University of Traditional Chinese Medicine, Putuo District Central Hospital, Shanghai, Shanghai Municipality, China
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