Observed Course of Diabetes Mellitus and Inferences Concerning Its Origin and Progress

Colwell, Arthur R.

doi:10.1001/archinte.1942.00200220013002

Cited by 14 publications

(2 citation statements)

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“…It was suggested by Constam [26] and by Caird et al [16] that the first few years of treatment are critical: diabetics whose diabetes has been well controlled in the first few years and poorly controlled later on have fewer late complications than those with the reverse sequence. Among old studies [28][29][30][31] showing inconclusive results was that by Dolger, often cited to support the lack of any beneficial effect of good control [30]. According to Pirart and Lauvaux, however, Dolger's methods do not stand up to even superficial criticism because the criteria of control were not given [21,32].…”

Section: Clinical Studiesmentioning

confidence: 99%

Relation of diabetic control to development of microvascular complications

Tchobroutsky

1978

Diabetologia

401

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Summary. This review seeks to supply the arguments which support or deny the relationship between the quality of control of blood glucose levels and the course of diabetic microangiopathy. The ideal study is impossible to do in man but most prospective studies suggest that the better the control the slower the rate of progression and severity of lesions. "Scientific" but indirect arguments from biochemical, enzymatic and functional studies have shown that insulin and/or blood glucose control reverse some early diabetic changes that are probably related to the late events. Recent studies suggest that observations on animals that have shown the beneficial effect of treatment are relevant to the problem of diabetic microvascular lesions in man. Heredity influences the development of diabetic microangiopathy in diabetics but retinal and/or glomerular lesions -which are definitely not pathognomonic for diabetes -do not appear in the absence of hyperglycaemia. Muscle capillary basement membrane thickening that seems not to be a specific abnormality was not observed by several investigators in recently diagnosed diabetics. Therefore most of the arguments that have been given to support the point of view that tight control is not justified may be rejected. The opinion of the author is that strict control of diabetes is worthwile in patients with long life expectancy and no psychological, social or cultural handicaps.

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Section: Clinical Studiesmentioning

confidence: 99%

Relation of diabetic control to development of microvascular complications

Tchobroutsky

1978

Diabetologia

401

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“…The prediabetic state is a decided entity. 106 " 108 Pomeranze 107 wrote: "A chronic disease process always exists in a preclinical state, in which its symptomatology is absent or vague, and its biochemical and metabolic changes are minimal and nonspecific. At such time, diagnostic reliance cannot be placed upon those obvious biochemical changes or gross clinical findings which are clearly evident only in the overt phase of the disease.…”

Section: Heredity and A Specific Effect Of Diabetesmentioning

confidence: 99%