CLINICAL SURVEY OF VASCULAR COMPLICATIONS IN "JUVENILE DIABETES MELLITUS"

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Abstract
In diabetes mellitus we are dealing primarily with a profound carbohydrate disturbance in which a state of hypoinsulinism plus imbalance of the anterior pituitary and adrenal cortical hormones are present. This extensive disturbance affects metabolic functions of many organs and tissues. Because of the interrelationship between carbohydrate, protein and fat and even mineral and water metabolism, there must be varying degrees of change both normal and abnormal, in all of these metabolic processes. The aberrations may be transitory or more prolonged, depending upon the persistence and severity of the metabolic derangement. Since no juvenile diabetic patient, even with the assistance of present-day insulin and prescribed diet, can respond in a completely physiologic manner to his food intake, activity, etc., we must expect metabolic deviations from the normal. It is logical to assume that the closer the approximation of the diabetic patient to a normal physiologic state, the more desirable it is and the less likely is he to suffer qualitatively and quantitatively from the results of his metabolic disorder. In this small series to date none of the patients whose control was considered good developed detectable vascular lesions even though they had the disease for 10 to 28 years. This survey adds to the slowly accumulating clinical data indicating decided benefits of a well controlled diabetic state in humans.

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