Rev Diabet Stud, 2006, 3(3):108-117 DOI 10.1900/RDS.2006.3.108

Causes and Characteristics of Diabetic Cardiomyopathy

Jianxun Wang1, Ye Song2, Qianwen Wang3, Patricia M. Kralik2, Paul N. Epstein2

1Departments of Pharmacology and Toxicology, University of Louisville, Louisville, KY 40202, USA.
2Department of Pediatrics, University of Louisville, Louisville, KY 40202, USA.
3Department of Physiology and Biophysics, University of Louisville, Louisville, KY 40202, USA.
Address correspondence to: Paul N. Epstein, e-mail:


Type 1 and type 2 diabetic patients are at increased risk of cardiomyopathy and heart failure is a major cause of death for these patients. Cardiomyopathy in diabetes is associated with a cluster of features including decreased diastolic compliance, interstitial fibrosis and myocyte hypertrophy. The mechanisms leading to diabetic cardiomyopathy remain uncertain. Diabetes is associated with most known risk factors for cardiac failure seen in the overall population, including obesity, dyslipidemia, thrombosis, infarction, hypertension, activation of multiple hormone and cytokine systems, autonomic neuropathy, endothelial dysfunction and coronary artery disease. In light of these common contributing pathologies it remains uncertain whether diabetic cardiomyopathy is a distinct disease. It is also uncertain which factors are most important to the overall incidence of heart failure in diabetic patients. This review focuses on factors that can have direct effects on diabetic cardiomyocytes: hyperglycemia, altered fuel use, and changes in the activity of insulin and angiotensin. Particular attention is given to the changes these factors can have on cardiac mitochondria and the role of reactive oxygen species in mediating injury to cardiomyocytes.

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Rev Diabet Stud, 2006, 3(3):118-126 DOI 10.1900/RDS.2006.3.118

Diet, Exercise and the Metabolic Syndrome

Christos Pitsavos1, Demosthenes Panagiotakos2, 3, Christodoulos Stefanadis1

1First Cardiology Clinic, School of Medicine, University of Athens, Athens, Greece.
2Department of Nutrition and Dietetics, Harokopio University, Athens, Greece.
3Society for Biomedical Diabetes Research, Duisburg, Germany.
Address correspondence to: Demosthenes B. Panagiotakos, e-mail:


The metabolic syndrome is a combination of metabolic disorders, such as dyslipidemia, hypertension, impaired glucose tolerance, compensatory hyperinsulinemia and the tendency to develop fat around the abdomen. Individuals with the metabolic syndrome are at high risk for atherosclerosis and, consequently, cardiovascular disease. However, as a result of several epidemiologic studies and some clinical trials, it has been suggested that people with the metabolic syndrome may benefit from intensive lifestyle modifications including dietary changes and adopting a physically more active lifestyle. In this review we summarize the effects of diet and physical activity on the development of the metabolic syndrome.

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