In hypoxic tissues these vascular changes are linked to metabolic imbalances associated with impaired oxidation of NADH to NAD and the resulting increased ratio of NADH/NAD.

In hyperglycemic tissues these vascular changes also are linked to an increased ratio of NADH/NAD, in this case because of an increased rate of reduction of NAD to NADH.

Several lines of evidence support the likelihood that the increased cytosolic ratio of free NADH/NAD caused by hyperglycemia, referred to as pseudohypoxia because tissue partial pressure oxygen is normal, is a characteristic feature of poorly controlled diabetes that mimics the effects of true hypoxia on vascular and neural function and plays an important role in the pathogenesis of diabetic complications.

About the Authors

Williamson JR, Chang K, Frangos M, Hasan KS, Ido Y, Kawamura T, Nyengaard JR, van den Enden M, Kilo C, Tilton RG. (1993. Hyperglycemic Pseudohypoxia and Diabetic Complications. Diabetes 1993 Jun;42(6):801-13. Department of Pathology, Washington University School of Medicine, St. Louis, Missouri).