VASCULAR LESIONS IN DIABETES MELLITUS

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Abstract
ATHEROSCLEROSIS, medical sclerosis, and arteriolar sclerosis all occur more frequently in diabetic than in nondiabetic patients. The clinical features of these conditions in diabetics were reviewed in previous reports.* As a cause of morbidity and mortality, atherosclerosis is the most important form of arteriosclerosis by far. As has been pointed out elsewhere,4 it is agreed at present that the specific lesions of diabetes are in the capillaries and venules of the retina and glomerulus, i. e., retinopathy and intercapillary glomerulosclerosis (Kimmelstiel-Wilson disease). Diabetic retinopathy passes through successive stages, beginning with the microaneurysm and lesions of the venules. The exudates are small, pinpoint lesions in the early stages, coalesce to form larger, waxy exudates, but do not take on the star-shaped configuration one sees, for example, in albuminuric retinopathy. In the final stage there is hemorrhage into the vitreous and/or the fully developed picture of retinitis proliferans. Very recently, Ashton