Vascular Lesions in Diabetes Mellitus

Treatment of Diabetic Retinopathy With Estrogens

“…The latter clinical counterpart is distinctly unusual, however, considering the number of patients who have received steroids. A similar situation pertains in patients with Cushing's syndrome; diabetic retinopathy is rarely observed in these cases, in spite of the surplus secretion of “diabetogenic” hormones (9). Furthermore, attempts at reproduction of these lesions by the same investigator and by others have proven disappointing.…”

“…A great body of data can be used as evidence for a significant relationship between the incidence and severity of retinopathy and the degree of diabetic control (1). Admittedly, patients in whom diabetes is poorly controlled in association with multiple attacks of keto‐acidosis are prone to a more rapid development of the retinopathy (9). Nevertheless, the repeated observation of conscientious young diabetics whose retinopathy has progressed in spite of their best efforts is sobering.…”

“…It has been postulated that hypophysectomy might be of benefit because it checks adrenocortical hyperfunction and specifically prevents the elaboration of diabetogenic pituitary somatotropin (89). “Medical adrenalectomy” or “medical hypophysectomy” has been attempted with testosterone, progesterone, or pituitary radiation (9). As previously noted, the beneficial effects of hypophyseal stalk section have been attributed to an effect upon some humoral factor elaborated by the pituitary or hypothalamus (16 b ).…”

“…Drug therapy. Criticism directed toward drug therapy in the management of diabetic retinopathy is justifiable, in view of the initial, but transient, enthusiasm for the host of agents that have failed to live up to the claims made for them (3–10). Furthermore, one has to consider wide variations in the rate of resorption of intraocular hemorrhages.…”

“…In another recent review (9) the following statement is made. “There is good evidence that rutin and other orally administered flavonoids are destroyed by the intestinal flora.…”