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Review
. 2025 Jul;22(7):482-496.
doi: 10.1038/s41569-024-01115-w. Epub 2025 Jan 13.

Atherosclerosis in diabetes mellitus: novel mechanisms and mechanism-based therapeutic approaches

Abdul Waheed Khan  1 , Karin A M Jandeleit-Dahm  2   3
Affiliations
Review

Atherosclerosis in diabetes mellitus: novel mechanisms and mechanism-based therapeutic approaches

Abdul Waheed Khan et al. Nat Rev Cardiol. 2025 Jul.

Abstract

Atherosclerosis is a disease of large and medium arteries that can lead to life-threatening cardiovascular and cerebrovascular consequences, such as myocardial infarction and stroke. Moreover, atherosclerosis is a major contributor to cardiovascular-related mortality in individuals with diabetes mellitus. Diabetes aggravates the pathobiological mechanisms that underlie the development of atherosclerosis. Currently available anti-atherosclerotic drugs or strategies solely focus on optimal control of systemic risk factors, including hyperglycaemia and dyslipidaemia, but do not adequately target the diabetes-exacerbated mechanisms of atherosclerotic cardiovascular disease, highlighting the need for targeted, mechanism-based therapies. This Review focuses on emerging pathological mechanisms and related novel therapeutic targets in atherosclerotic cardiovascular disease in patients with diabetes.

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Conflict of interest statement

Competing interests: The authors declare no competing interests.

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