Diabetes mellitus associated neurovascular lesions in the retina and brain: A review

Diabetes mellitus (DM) is now recognized as a system-wide, autoimmune, inflammatory, microvascular disorder, which, in the retina and brain results severe multifocal injury leading cause, world-wide, of progressive vision loss dementia. To address this problem, resulting primarily from variations glycemia prediabetic overt diabetic states, it must be realized that, although some processes associated with diabetes may system wide, there are varying responses, effector, repair mechanisms that differ organ to or within cell structures. Specifically, retina, similarly cortex, lesions occur “neurovascular unit”, comprised focal occlusions, inflammatory endothelial pericyte injury, small vessel leakage astrocytes, Müller cells, microglia, all which neuronal apoptosis. Such before first microaneurysms visible imaging by fundus cameras they result detectable symptoms signs recognizable patient clinician. Treatments, therefore, currently not initiated until edema develops progression vascular define current staging retinopathy, only after cognitive failure. therefore applied relatively late reduction cellular but resultant minimal improvement. This review article will summarize multiple remediation understood patients well pre-diabetes limitations methods for assessing structural functional alterations brain. The goal attempt future screening, monitoring, treatment directions hopefully prevent enable improved attendant function.