Skip to main content
  • More from ADA
    • Diabetes Care
    • Clinical Diabetes
    • Diabetes Spectrum
    • ADA Standards of Medical Care in Diabetes
    • ADA Scientific Sessions Abstracts
    • BMJ Open Diabetes Research & Care
  • Subscribe
  • Log in
  • Log out
  • My Cart
  • Follow ada on Twitter
  • RSS
  • Visit ada on Facebook
Diabetes

Advanced Search

Main menu

  • Home
  • Current
    • Current Issue
    • Online Ahead of Print
    • ADA Scientific Sessions Abstracts
  • Browse
    • By Topic
    • Issue Archive
    • Saved Searches
    • ADA Scientific Sessions Abstracts
    • Diabetes COVID-19 Article Collection
    • Diabetes Symposium 2020
  • Info
    • About the Journal
    • About the Editors
    • ADA Journal Policies
    • Instructions for Authors
    • Guidance for Reviewers
  • Reprints/Reuse
  • Advertising
  • Subscriptions
    • Individual Subscriptions
    • Institutional Subscriptions and Site Licenses
    • Access Institutional Usage Reports
    • Purchase Single Issues
  • Alerts
    • E­mail Alerts
    • RSS Feeds
  • Podcasts
    • Diabetes Core Update
    • Special Podcast Series: Therapeutic Inertia
    • Special Podcast Series: Influenza Podcasts
    • Special Podcast Series: SGLT2 Inhibitors
    • Special Podcast Series: COVID-19
  • Submit
    • Submit a Manuscript
    • Submit Cover Art
    • ADA Journal Policies
    • Instructions for Authors
    • ADA Peer Review
  • More from ADA
    • Diabetes Care
    • Clinical Diabetes
    • Diabetes Spectrum
    • ADA Standards of Medical Care in Diabetes
    • ADA Scientific Sessions Abstracts
    • BMJ Open Diabetes Research & Care

User menu

  • Subscribe
  • Log in
  • Log out
  • My Cart

Search

  • Advanced search
Diabetes
  • Home
  • Current
    • Current Issue
    • Online Ahead of Print
    • ADA Scientific Sessions Abstracts
  • Browse
    • By Topic
    • Issue Archive
    • Saved Searches
    • ADA Scientific Sessions Abstracts
    • Diabetes COVID-19 Article Collection
    • Diabetes Symposium 2020
  • Info
    • About the Journal
    • About the Editors
    • ADA Journal Policies
    • Instructions for Authors
    • Guidance for Reviewers
  • Reprints/Reuse
  • Advertising
  • Subscriptions
    • Individual Subscriptions
    • Institutional Subscriptions and Site Licenses
    • Access Institutional Usage Reports
    • Purchase Single Issues
  • Alerts
    • E­mail Alerts
    • RSS Feeds
  • Podcasts
    • Diabetes Core Update
    • Special Podcast Series: Therapeutic Inertia
    • Special Podcast Series: Influenza Podcasts
    • Special Podcast Series: SGLT2 Inhibitors
    • Special Podcast Series: COVID-19
  • Submit
    • Submit a Manuscript
    • Submit Cover Art
    • ADA Journal Policies
    • Instructions for Authors
    • ADA Peer Review
Perspectives in Diabetes

Microvascular Complications of Impaired Glucose Tolerance

  1. J. Robinson Singleton1,
  2. A. Gordon Smith12,
  3. James W. Russell3 and
  4. Eva L. Feldman3
  1. 1Department of Neurology, University of Utah, Salt Lake City, Utah
  2. 2Department of Pathology, University of Utah, Salt Lake City, Utah
  3. 3Department of Neurology, University of Michigan, Ann Arbor, Michigan
  1. Address correspondence and reprint requests to Eva L. Feldman, Professor and Director, JDRF Center for the Study of Complications in Diabetes, University of Michigan, Department of Neurology, 4414 Kresge III 200 Zina Pitcher Place, Ann Arbor, MI 48109. E-mail: efeldman{at}umich.edu
Diabetes 2003 Dec; 52(12): 2867-2873. https://doi.org/10.2337/diabetes.52.12.2867
PreviousNext
  • Article
  • Figures & Tables
  • Info & Metrics
  • PDF
Loading

Article Figures & Tables

Figures

  • Tables
  • FIG. 1.
    • Download figure
    • Open in new tab
    • Download powerpoint
    FIG. 1.

    Disruption of vascular NO signaling and direct metabolic injury contribute to IGT complications. NO synthesized by eNOS mediates large- and small-vessel vasodilation and promotes endothelial thrombolysis. Transient or sustained hyperglycemia depletes NADPH and increases formation of ROS. ROS directly damage endothelial and other target organ cells and alter utilization of NO from vasoregulatory tasks to detoxification of ROS. AGEs increase ROS formation and cause direct metabolic injury. These synergistic insults promote small-tissue ischemia, large-vessel atherogenesis and thrombogenesis, and contribute to complications in IGT.

  • FIG. 2.
    • Download figure
    • Open in new tab
    • Download powerpoint
    FIG. 2.

    Adipocyte lipolysis, release of FFAs, and changes in adipocytokines in response in states of insulin resistance and obesity contribute to both acute changes in vasoreactivity and chronic endothelial injury. Increased circulating FFAs reinforce insulin resistance and increase gluconeogenesis in the liver, accelerating hyperglycemia and feeding into the hyperglycemic effects described in Fig. 1. Fatty acid peroxidaton directly increases ROS, and FFAs contribute to endothelial injury. Insulin resistance increases adipocyte release of tumor necrosis factor-α (TNF-α), which acts through the sphingolipid ceramide to damage endothelial cells. Adiponectin secretion is reduced, with inhibition of its vasoprotectve effect.

Tables

  • Figures
  • TABLE 1

    1997 ADA criteria (4) for IFG, IGT, and diabetes

    ConditionFasting plasma glucose (mg/dl)Test and values 2-h OGTT (mg/dl)HbA1c (%)
    Normal≤109≤139NA
    IFG110–125NANA
    IGTNA140–199NA
    Diabetes≥126≥200Variable
    • IFG is preferred to IGT by the ADA because of its greater convenience, but IFG and IGT are regarded as equivalent. The ADA recommends against use of HbA1c as a diagnostic test for diabetes. HbA1c threshold for diabetes is variable, but typically between 6.1 and 7.0%. No HbA1c values are recognized as equivalent to IGT or IFG.

PreviousNext
Back to top

In this Issue

December 2003, 52(12)
  • Table of Contents
  • Index by Author
Sign up to receive current issue alerts
View Selected Citations (0)
Print
Download PDF
Article Alerts
Sign In to Email Alerts with your Email Address
Email Article

Thank you for your interest in spreading the word about Diabetes.

NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
Microvascular Complications of Impaired Glucose Tolerance
(Your Name) has forwarded a page to you from Diabetes
(Your Name) thought you would like to see this page from the Diabetes web site.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
Citation Tools
Microvascular Complications of Impaired Glucose Tolerance
J. Robinson Singleton, A. Gordon Smith, James W. Russell, Eva L. Feldman
Diabetes Dec 2003, 52 (12) 2867-2873; DOI: 10.2337/diabetes.52.12.2867

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
Add to Selected Citations
Share

Microvascular Complications of Impaired Glucose Tolerance
J. Robinson Singleton, A. Gordon Smith, James W. Russell, Eva L. Feldman
Diabetes Dec 2003, 52 (12) 2867-2873; DOI: 10.2337/diabetes.52.12.2867
del.icio.us logo Digg logo Reddit logo Twitter logo CiteULike logo Facebook logo Google logo Mendeley logo
  • Tweet Widget
  • Facebook Like
  • Google Plus One

Jump to section

  • Article
    • Abstract
    • Recognition and natural history of IGT.
    • Microvascular complications of IGT: neuropathy, retinopathy, and renal microproteinuria.
    • Pathogenesis of IGT complications: general considerations.
    • Hyperglycemia inhibits nitric oxide-mediated vasodilation.
    • Insulin resistance.
    • FFAs and adipocytokines induce endothelial injury.
    • Other metabolic effects of hyperglycemia.
    • Treatment and areas for future study.
    • Acknowledgments
    • Footnotes
    • REFERENCES
  • Figures & Tables
  • Info & Metrics
  • PDF

Related Articles

Cited By...

More in this TOC Section

  • Regulation of Hepatic Metabolism and Cell Growth by the ATF/CREB Family of Transcription Factors
  • Modulation of Leukocytes of the Innate Arm of the Immune System as a Potential Approach to Prevent the Onset and Progression of Type 1 Diabetes
  • Emerging Role of Bone Morphogenetic Protein 4 in Metabolic Disorders
Show more Perspectives in Diabetes

Similar Articles

Navigate

  • Current Issue
  • Online Ahead of Print
  • Scientific Sessions Abstracts
  • Collections
  • Archives
  • Submit
  • Subscribe
  • Email Alerts
  • RSS Feeds

More Information

  • About the Journal
  • Instructions for Authors
  • Journal Policies
  • Reprints and Permissions
  • Advertising
  • Privacy Policy: ADA Journals
  • Copyright Notice/Public Access Policy
  • Contact Us

Other ADA Resources

  • Diabetes Care
  • Clinical Diabetes
  • Diabetes Spectrum
  • Scientific Sessions Abstracts
  • Standards of Medical Care in Diabetes
  • BMJ Open - Diabetes Research & Care
  • Professional Books
  • Diabetes Forecast

 

  • DiabetesJournals.org
  • Diabetes Core Update
  • ADA's DiabetesPro
  • ADA Member Directory
  • Diabetes.org

© 2021 by the American Diabetes Association. Diabetes Print ISSN: 0012-1797, Online ISSN: 1939-327X.