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Antioxidants
Volume 14
Issue 1
10.3390/antiox14010072
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Review

Oxidative Stress and Cardiovascular Complications in Type 2 Diabetes: From Pathophysiology to Lifestyle Modifications

by
Alfredo Caturano
1,2,
Maria Rocco
1,
Giuseppina Tagliaferri
1,
Alessia Piacevole
1,
Davide Nilo
1,
Giovanni Di Lorenzo
1,
Ilaria Iadicicco
1,
Mariarosaria Donnarumma
1,
Raffaele Galiero
1,
Carlo Acierno
3,
Celestino Sardu
1,
Vincenzo Russo
4,5,
Erica Vetrano
1,
Caterina Conte
2,6,
Raffaele Marfella
1,
Luca Rinaldi
7,* and
Ferdinando Carlo Sasso
1,*
1
Department of Advanced Medical and Surgical Sciences, University of Campania Luigi Vanvitelli, 80138 Naples, Italy
2
Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Roma Open University, 00166 Rome, Italy
3
Azienda Ospedaliera Regionale San Carlo, 85100 Potenza, Italy
4
Department of Biology, College of Science and Technology, Sbarro Institute for Cancer Research and Molecular Medicine, Temple University, Philadelphia, PA 19122, USA
5
Division of Cardiology, Department of Medical Translational Sciences, University of Campania Luigi Vanvitelli, Naples, Italy
6
Department of Endocrinology, Nutrition and Metabolic Diseases, IRCCS MultiMedica, 20099 Milan, Italy
7
Department of Medicine and Health Sciences “Vincenzo Tiberio”, Università degli Studi del Molise, 86100 Campobasso, Italy
*
Authors to whom correspondence should be addressed.
Antioxidants 2025, 14(1), 72; https://doi.org/10.3390/antiox14010072
Submission received: 11 December 2024 / Revised: 30 December 2024 / Accepted: 8 January 2025 / Published: 9 January 2025
(This article belongs to the Special Issue Oxidative Stress in Cardiovascular Diseases (CVDs))
Versions Notes

Abstract

Type 2 diabetes mellitus (T2DM) is a chronic metabolic disorder that significantly increases the risk of cardiovascular disease, which is the leading cause of morbidity and mortality among diabetic patients. A central pathophysiological mechanism linking T2DM to cardiovascular complications is oxidative stress, defined as an imbalance between reactive oxygen species (ROS) production and the body’s antioxidant defenses. Hyperglycemia in T2DM promotes oxidative stress through various pathways, including the formation of advanced glycation end products, the activation of protein kinase C, mitochondrial dysfunction, and the polyol pathway. These processes enhance ROS generation, leading to endothelial dysfunction, vascular inflammation, and the exacerbation of cardiovascular damage. Additionally, oxidative stress disrupts nitric oxide signaling, impairing vasodilation and promoting vasoconstriction, which contributes to vascular complications. This review explores the molecular mechanisms by which oxidative stress contributes to the pathogenesis of cardiovascular disease in T2DM. It also examines the potential of lifestyle modifications, such as dietary changes and physical activity, in reducing oxidative stress and mitigating cardiovascular risks in this high-risk population. Understanding these mechanisms is critical for developing targeted therapeutic strategies to improve cardiovascular outcomes in diabetic patients.
Keywords: oxidative stress; type 2 diabetes mellitus; cardiovascular complications; lifestyle interventions; Mediterranean diet; pathophysiology oxidative stress; type 2 diabetes mellitus; cardiovascular complications; lifestyle interventions; Mediterranean diet; pathophysiology

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MDPI and ACS Style

Caturano, A.; Rocco, M.; Tagliaferri, G.; Piacevole, A.; Nilo, D.; Di Lorenzo, G.; Iadicicco, I.; Donnarumma, M.; Galiero, R.; Acierno, C.; et al. Oxidative Stress and Cardiovascular Complications in Type 2 Diabetes: From Pathophysiology to Lifestyle Modifications. Antioxidants 2025, 14, 72. https://doi.org/10.3390/antiox14010072

AMA Style

Caturano A, Rocco M, Tagliaferri G, Piacevole A, Nilo D, Di Lorenzo G, Iadicicco I, Donnarumma M, Galiero R, Acierno C, et al. Oxidative Stress and Cardiovascular Complications in Type 2 Diabetes: From Pathophysiology to Lifestyle Modifications. Antioxidants. 2025; 14(1):72. https://doi.org/10.3390/antiox14010072

Chicago/Turabian Style

Caturano, Alfredo, Maria Rocco, Giuseppina Tagliaferri, Alessia Piacevole, Davide Nilo, Giovanni Di Lorenzo, Ilaria Iadicicco, Mariarosaria Donnarumma, Raffaele Galiero, Carlo Acierno, and et al. 2025. "Oxidative Stress and Cardiovascular Complications in Type 2 Diabetes: From Pathophysiology to Lifestyle Modifications" Antioxidants 14, no. 1: 72. https://doi.org/10.3390/antiox14010072

APA Style

Caturano, A., Rocco, M., Tagliaferri, G., Piacevole, A., Nilo, D., Di Lorenzo, G., Iadicicco, I., Donnarumma, M., Galiero, R., Acierno, C., Sardu, C., Russo, V., Vetrano, E., Conte, C., Marfella, R., Rinaldi, L., & Sasso, F. C. (2025). Oxidative Stress and Cardiovascular Complications in Type 2 Diabetes: From Pathophysiology to Lifestyle Modifications. Antioxidants, 14(1), 72. https://doi.org/10.3390/antiox14010072

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