Clinical Evaluation of Vascular Damage in Diabetes Mellitus

The discovery of insulin twenty-five years ago served to avert the catastrophic threat to life represented by diabetes mellitus but unfortunately initiated an attitude of complacency in the members of the medical profession. What was intended as a palliative became the panacea; control of the blood sugar level was interpreted as control of the disease. But "maintenance of life is not sufficient in itself as a goal in the treatment of diabetes mellitus."1The optimism of that early period is now being dissipated by a number of anxious reports2on the mounting incidence of seemingly inevitable degenerative sequelae. Rosenbusch3has concluded a painstakingly thorough study of 88 diabetic children with the following: "The prognosis of diabetes in childhood—taking a long view—is in spite of the progress of dietary and insulin treatment more adverse than had originally been expected." Joslin4has found evidence of vascular damage in