Vascular reactivity in diabetes mellitus.

A patient with type 2 diabetes carries a cardiovascular risk similar to that of a non-diabetic with a prior history of myocardial infarction. Endothelial dysfunction, an early event in the pathogenesis of atherosclerosis is present in diabetes mellitus in the absence of clinical cardiovascular disease. The assessment of the endothelium dependent vasodilatory effect in response to various stimuli known to increase NO (nitric oxide) production is termed vascular reactivity1,2. Vascular reactivity has been assessed in conduit arteries, forearm resistance vessels capillaries and vein in diabetes. The cerebral, myocardial, skeletal muscle, renal, skin and penile blood vessels in type 1 and type 2 diabetes have been shown to have abnormal vascular reactivity. It is possible that impaired vascular reactivity may contribute to the clinical manifestations of cardiovascular disease, the pathogenesis of nephropathy, diastolic dysfunction, foot ulcers and erectile dysfunction in subjects with diabetes mellitus2,3.