C-Peptide: Connecting diabetes with macrovascular complications

The incidence of diabetes is increasing globally; the estimated prevalence in 2010 being 285 million worldwide (www.http://diabetes.org.uk). In the UK alone, the number of people diagnosed with diabetes has increased from 1.4 to 2.6 million since 1996 (www.http://diabetes.org.uk). These individuals are at high risk of cardiovascular disease and in this population coronary artery disease (CAD) is common, regularly manifesting itself earlier in life than in individuals without diabetes [1]. While strategies that maintain tight glucose control have been reported to ameliorate some of the microvascular complications of diabetes (retinopathy, nephropathy, neuropathy) [2], this approach appears to have little or no benefit in the macrovasculature [3]. A greater understanding of the complexity of the diabetic milieu may therefore be invaluable in exposing therapeutic targets to reduce the incidence of macrovascular diseases in diabetes.