MEDICAL HYPOTHESES AND RESEARCH
VOL. 5, No. 1/2, July 2009
L. M. Agius  Med. Hypotheses Res. 5: 71‒77.
Microvascular Endothelial Cell Susceptibility Patterns as
Template for Progressive Ischemia in Diabetes Mellitus
Lawrence M. Agius*
Department Of Pathology, Mater Dei Hospital, Tal-Qroqq, Malta Europe
Abstract. Revolving susceptibility spectra of involvement of endothelial pathobiology
would operatively entail a further complex interactivity based on primal template
functionality or dysfunctionality. One might view the further realized involvement of tissues
and organs within specific redefined concepts of ischemia and reperfusion injury largely as a
result of such template pathobiology exhibited by endothelium of the microvasculature. It is
in the further reconstructive remodeling of injury to tissues and organs beyond simple flow
disturbance of hemodynamic type that there would further evolve a real or parallel
representation of injury of ischemic type based on beta islet cell microvascular pathobiology.
Insulin action and peripheral insulin resistance would operatively also implicate secretory
dysfunctionality within schemes of further injury as exhibited by both microvasculopathy
and atherogenesis in diabetes mellitus patients. The added exquisite sensitivity of
cardiomyocytes and neurons to ischemia further compounds pathobiology of template
dysfunctionality of microvascular endothelium.
* Correspondence: Dr. Lawrence M. Agius, 27 “Ballarat” Guzeppe Caruana Street,
Tal-Virtu Rabat Rbt09, Malta Europe. Tel: 356-2145-1752 or 356-2545-6444. Fax: 356-
216449. E-mail: Lawrence.Agius@um.edu.mt or Lawrence.Agius@gov.mt