[Physiopathology of atherosclerosis in diabetics].

Vascular diseases, especially atherosclerosis, are the main cause of morbidity and mortality in diabetics. Diabetes greatly increases the risk of developing coronary heart disease, cerebral vascular accident and lower limb arteritis. The physiopathology of vascular disease in the diabetic patient involves endothelial and smooth muscle cell abnormalities. Metabolic disturbances which are characteristic of diabetes, such as hyperglycaemia or AGE accumulation, contribute to endothelial dysfunction and augment the inflammatory response at the vascular level. Atherosclerotic plaques in diabetics are more inflammatory than in non-diabetics, with an accumulation of macrophages and T lymphocytes, a larger lipid core and the presence of a greater number of macrophages and smooth muscle cells in apoptosis, which makes them more vulnerable.