The Relationship of Abnormal Vascular Responses to Retinopathy and Nephropathy in Diabetics

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Abstract
The increasing importance of vascular disease in the diabetic is reflected in recent mortality studies. Whereas in the preinsulin era approximately 18% died of cardiorenal vascular disease, this figure had risen to 54% in 1936 and to as much as 76% in 1955.1 Furthermore, in juvenile diabetics surviving 25 to 30 years of their disease, 88% have retinopathy (46% retinitis proliferans), 39% have albuminuria, and 44% hypertension.2 Only little is known about the etiology and pathogenesis of the vascular disease. It is evident, however, that the more specific lesions, retinopathy and glomerulosclerosis, result from a slowly progressive degeneration of the smaller blood vessels. Retinopathy and glomerulosclerosis are related to various factors, including the duration of diabetes.3,4 With use of an ophthalmoscope (magnification X 15), the initial visible change found in the retinopathy of young diabetics is venous congestion (phlebopathy) and small sanguinolent dots (microaneurysms).5,6 By using

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