Retinal damage (from microangiopathy) makes it the most common cause of blindness among non-elderly adults in the US.
In addition to direct glucose-induced damage by (e.g.) glycation,[4] pericytes, express enzymes which convert glucose into osmotically active metabolites such as sorbitol leading to hypertonic cell lysis.
[5] The enzyme, namely aldose reductase, is also expressed in the endothelial and Schwann cells of the peripheral nervous system, contributing to diabetic neuropathy.
[6] Over time, pericyte death may result in reduced capillary integrity; subsequently, there is leaking of albumin and other proteins into fluid compartments.
[7] Prognosis is generally poor for all forms of diabetic angiopathy, as symptomatology is tied to the advancement of the underlying pathology i.e. the early-stage patient displays either non-specific symptoms or none at all.