Angioscopic changes in the smaller blood vessels in diabetes mellitus and their relationship to aging.


UNTIL recently the vascular lesions in diabetes mellitus have been considered "arteriosclerotic" in origin. It was said that the high incidence of malignant vascular disease was due to an accelerating effect of diabetes upon the development of arteriosclerosis and normal aging.'. 2 Lately, there has been a change in opinion on this point and more investigators now regard the diabetic vascular syndrome as a specific entity characteristic of the disease.3 4 This belief is mostly based on the fact that diabetic retinopathy and intercapillary glomerulosclerosis, both involving small blood vessels, show some characteristic morphologic features easily distinguishable from those of arteriosclerosis.5' 6 Evidence at present suggests that the diabetic lesions in the retina and the kidney are various manifestations of one generalized, slowly developing disease in the smaller blood vessels (diabetic microangiopathy). The increased fragility of the small blood vessels in the subcutaneous tissue of long-term diabetic subjects indicates the extensiveness of this microangiopathy.7' 8 Further information as to the nature of these changes can be obtained by studying other vascular beds of diabetic subjects. The bulbar conjunctiva offers unique possibilities for direct biomicroscopic observations of the smaller blood vessels and the circulating blood.9 These

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@article{Ditzel1956AngioscopicCI, title={Angioscopic changes in the smaller blood vessels in diabetes mellitus and their relationship to aging.}, author={J\orn Ditzel}, journal={Circulation}, year={1956}, volume={14 3}, pages={386-97} }