The article "Diabetic Vasculopathy: Molecular Mechanisms and Clinical Insights" by George Jia et al. provides a comprehensive overview of the molecular and clinical aspects of diabetic vasculopathy, a condition characterized by microvascular and macrovascular complications in patients with diabetes mellitus. The authors highlight the significant impact of hyperglycemia and insulin resistance/hyperinsulinemia on the development and progression of diabetic vasculopathy, which includes retinopathy, neuropathy, atherosclerosis, coronary artery disease, hypertension, and peripheral artery disease. The review discusses the underlying mechanisms, such as inappropriate activation of the renin-angiotensin-aldosterone system (RAAS), mitochondrial dysfunction, excessive oxidative stress, inflammation, dyslipidemia, and thrombosis. These factors collectively contribute to the metabolic disorders and further exacerbate diabetic vasculopathy. Recent evidence also suggests that endothelial progenitor cell dysfunction, gut dysbiosis, and the abnormal release of extracellular vesicles and their microRNAs play crucial roles in the development and progression of diabetic vasculopathy. The article emphasizes the importance of clinical control and treatment of diabetes mellitus, as well as the development of novel therapeutic strategies, to prevent cardiometabolic syndrome and related diabetic vasculopathy. It highlights the need for lifestyle modifications, glycemic control, antithrombotic therapy, and lipid-lowering and antihypertensive treatments to reduce the risk of cardiovascular events and total mortality in diabetic patients. The authors conclude that understanding the pathophysiology of insulin resistance and diabetes mellitus and associated vascular complications is essential for the identification and development of novel treatments to prevent and treat diabetic vasculopathy.The article "Diabetic Vasculopathy: Molecular Mechanisms and Clinical Insights" by George Jia et al. provides a comprehensive overview of the molecular and clinical aspects of diabetic vasculopathy, a condition characterized by microvascular and macrovascular complications in patients with diabetes mellitus. The authors highlight the significant impact of hyperglycemia and insulin resistance/hyperinsulinemia on the development and progression of diabetic vasculopathy, which includes retinopathy, neuropathy, atherosclerosis, coronary artery disease, hypertension, and peripheral artery disease. The review discusses the underlying mechanisms, such as inappropriate activation of the renin-angiotensin-aldosterone system (RAAS), mitochondrial dysfunction, excessive oxidative stress, inflammation, dyslipidemia, and thrombosis. These factors collectively contribute to the metabolic disorders and further exacerbate diabetic vasculopathy. Recent evidence also suggests that endothelial progenitor cell dysfunction, gut dysbiosis, and the abnormal release of extracellular vesicles and their microRNAs play crucial roles in the development and progression of diabetic vasculopathy. The article emphasizes the importance of clinical control and treatment of diabetes mellitus, as well as the development of novel therapeutic strategies, to prevent cardiometabolic syndrome and related diabetic vasculopathy. It highlights the need for lifestyle modifications, glycemic control, antithrombotic therapy, and lipid-lowering and antihypertensive treatments to reduce the risk of cardiovascular events and total mortality in diabetic patients. The authors conclude that understanding the pathophysiology of insulin resistance and diabetes mellitus and associated vascular complications is essential for the identification and development of novel treatments to prevent and treat diabetic vasculopathy.