Emerging Role of PACAP as a New Potential Therapeutic Target in Major Diabetes Complications

Table 1

Main complications associated with longstanding diabetes.

Complication	Description
Micro- and macroangiopathy (diabetic endothelial dysfunction)	They are distinctive phenotypes found in both types of diabetes, which are responsible for the high incidence of stroke, heart attack, and organ damage in diabetic patients.
Pancreatic islets dysfunction	It is a progressive dysfunction of pancreatic islet alpha and beta cells, caused either by cell death or dedifferentiation in immature fetal or neonatal-like state with impaired glucose-stimulated insulin secretion which results in inadequate control of hyperglycemia.
Diabetic retinopathy (DR)	It damages the small blood vessels that serve the retina, with loss of visual ability. Further morbidity states associated with DR and diabetes are the increased probability to develop eye diseases such as glaucoma and cataracts.
Diabetic nephropathy	It is a progressive reduction of the filter function of the kidney that, if untreated, can lead to renal failure up to the need of dialysis and/or kidney transplant.
Diabetic neuropathy	It is one of the most frequent complications and according to the World Health Organization is manifested at different levels in 50% of diabetics. It can cause loss of sensitivity, pain of varying intensity, damage to limbs, requiring amputation in more severe cases, and increase in vascular permeability. It may involve heart dysfunction of the eyes and stomach and is a major cause of male impotence.