Impact of Exosomes on the Pathogenesis of Diabetes and Its Complications

Abstract

Diabetes mellitus (DM) encompasses a range of metabolic disorders characterized by chronic hyperglycemia, including type 1 diabetes mellitus (T1DM), type 2 diabetes mellitus (T2DM), and gestational diabetes mellitus (GDM). The pathophysiology of DM is intricate, exhibiting variations across its different types, involving factors such as autoimmunity, insulin resistance, and β-cell dysfunction. Prolonged hyperglycemia in DM leads to microvascular and macrovascular complications, driven by various pathophysiological processes such as inflammation, coagulation, oxidative stress, and endothelial dysfunction. Exosomes, a specific type of extracellular vesicles (EVs), are recognized contributors to the aforementioned pathological processes and are thus implicated in the pathogenesis of diabetes and its associated complications. This work begins with summarizing the key characteristics, biogenesis, composition, and essential physiological and pathological functions of exosomes. It then focuses on collating and analyzing the most recent data on the pathogenic roles of exosomes in T1DM, T2DM, GDM, and diabetes-associated complications, such as diabetic retinopathy, nephropathy, neuropathy, and cardiomyopathy.