# Diabetes Mellitus and Cardiopulmonary Bypass (CPB): Pathophysiological Mechanisms Related to Inflammation and Cardiovascular Disease

## TL;DR

This paper reviews how diabetes-related inflammation contributes to cardiovascular disease and affects outcomes in heart surgery involving cardiopulmonary bypass.

## Contribution

The paper provides a narrative review connecting T2DM inflammation, cardiovascular disease, and the inflammatory effects of cardiopulmonary bypass surgery.

## Key findings

- T2DM is associated with chronic low-grade inflammation due to insulin resistance and obesity.
- This inflammation contributes to cardiovascular disease and worsens outcomes in CPB surgery.
- CPB surgery itself induces an inflammatory response that may interact with pre-existing T2DM inflammation.

## Abstract

Type 2 Diabetes Mellitus (T2DM) is a chronic disease caused by the resistance of tissues to the actions of insulin as well as the progressive failure to produce adequate amounts of insulin in pancreatic β-cells. Research has further shown that T2DM is characterized by a generalized state of low-grade inflammation; this inflammation is often related to overnutrition and obesity leading to an excess storage of lipid particles in adipose cells. Eventually, this will stimulate the pathophysiological pathways of cellular stress and inflammation. The inflammation characterizing T2DM can then contribute, along with other mechanisms of hyperglycemia, to the emergence of cardiovascular disease. Due to the resulting heart disease, many patients with T2DM may be inevitably required to undergo cardiac surgery with cardiopulmonary bypass (CPB), a process also characterized by an intense inflammatory response with possible effects and disruptions in immune system functions. It is thus the purpose of this narrative review to summarize and present evidence in the literature related to the inflammatory interplay occurring between T2DM, cardiovascular disease, and cardiac surgery with CPB.