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2015, Number 4

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Rev Mex Anest 2015; 38 (4)

Metabolic memory and cardiovascular complications in diabetic patients

Luna-Ortiz P, Flores-Chávez PL, Guarner-Lans V, Machado-Diaz AM, Olivares-Sanromán ME, Martínez-Rosas M

Language: Spanish
References: 98
Page: 249-263
PDF size: 437.26 Kb.


ABSTRACT

Diabetes mellitus is considered a pandemic at present and is a disease commonly found during anesthesia. It represents an independent risk factor morbidity and mortality in major surgeries. At present the pharmacological tools that we have are not enough to halt and reverse the vascular alterations typical of the DM, including the microvascular ones. The comprehensive evaluation of the diabetic patient should consider the history of the disease and in particular the presence of metabolic memory that is defined as the long-term effect of a previous prolonged hyperglycemic condition that leads to the development of vascular complications. Large randomized studies have shown that intensive control of blood sugar early can reduce the incidence and progression of micro and macrovascular complications in these patients while periods of chronic hyperglycemia due to poor control, especially during the initial stages of diabetes, leaves a cell mark allowing the development and progression of vascular complications, even when the euglycemic control is achieved. Therefore, the metabolic memory is a condition that may explain the vascular complications in surgical results in the short and long term. In this review, we provide the anesthesiologist an overview of the phenomenon describing the possible pathophysiological mechanisms at the cellular and molecular level and discuss the therapeutic implications for the management of this condition. Therefore, the metabolic memory is a condition that may explain the vascular complications in surgical results in the short and long term. In this review, we provide the anesthesiologist an overview of the phenomenon describing the possible pathophysiological mechanisms at the cellular and molecular level and discuss the therapeutic implications for the management of this condition.


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