VASCULAR-PERMEABILITY IN DIABETICS AND IMPLICATIONS FOR THERAPY

Several factors contribute to increased vascular permeability in diabe tes mellitus, namely hyperglycaemia leading to increased production of diacylglycerol and thence protein kinase C, non-enzymatic glucosylati on generating free radicals and lipid peroxides, sorbitol formation, l oss of endothelial cell surface heparan sulphates, and the action of a rachidonate derivatives that affect endothelial cell contractility. In view of the importance of oxidative damage, serious consideration mus t be given to therapeutic regimens that utilise vitamin E or ascorbic acid or D-myoinositol. Probucol is an available antioxidant whose prop erties have received insufficient attention. The oleate of monounsatur ated oil diets is likewise anti-oxidant. Furthermore there is a possib ility of replacing lost surface heparan sulphates.