Figure 1.

Diagram of the vascular wall: atherogenesis in the setting of diabetes. Exposure to atherogenic factors such as hyperglycemia, hyperlipidemia, excess flow-mediated stress (hypertension), or cigarette smoke results in over-production of inflammatory cytokines and reactive oxygen species, injuring the endothelium, causing vascular smooth muscle cell phenotype switching , allowing egress of lipoproteins into the subendothelial space, increasing adhesion molecule expression which attracts and activates platelets and monocytes/ macrophages, and foam cell formation³⁴. Diabetes accelerates plaque progression.

Reusch and Wang, JCEM 2011, Figure 1