Diabetes Mellitus and Its Degenerative Complications: A Prospective Study of 4,400 Patients Observed Between 1947 and 1973

Abstract

This article was originally published in French in Diabete et Metabolisme (vol. 3: 97–107, 173–182, 245–256; 1977). The Editors of DIABETES CARE thank the author, and the editors and publisher of Diabete et Metabolisme for granting permission for us to print this English translation. The paper was translated by Marjorie Levin of Miami, Florida. Part 2 of this translation will appear in the July–August issue of DIABETES CARE.

RETRACTED: Activation of protein kinase C by elevation of glucose concentration: proposal for a mechanism in the development of diabetic vascular complications.

“…Since an increase in DAG levels in the hearts of diabetic animals has recently been reported (41), we suggest that this activation ofPKC by glucose by means of de novo synthesis of DAG could be generalized to all vascular tissues involved in diabetic vascular complications. The elevation of PKC activities has been shown to alter many cellular functions that are common in diabetic vascular complications (1)(2)(3)(4)(5)(6)22), such as stimulating neovascularization (20), altering collagen synthesis (42), and affecting hormone and growth factor receptor recycling (12,43). In conclusion, we suggest that the alterations in the levels of metabolites encountered in pathophysiological state such as diabetes mellitus can affect PKC activities.…”

“…Hyperglycemia is probably an important etiologic factor in the development of vascular complications in diabetic patients, such as retinopathy (1), nephropathy (2), and accelerated atherosclerosis (3). Nonenzymatic glycosylation (4,5) of protein and accumulation of intracellular sorbitol with reduction of myo-inositol levels (6, 7) have been proposed to be involved in the development of these vascular changes.…”

Prevalence and risk factors for severity of diabetic neuropathy in type 2 diabetes mellitus

“…In the literature, the reported prevalence of neuropathy varies widely from 8.3 to 45%. [1][2][3][4][5][6] This variability could be due to variation in the population studied, type of diabetes, and the criteria used to assess diabetic neuropathy. A quantitative technique such as VPT that was used in this study provides several advantages: It is easier to administer, takes less time, and involves lower cost.…”

“…Up to 7.5% of patients with non-insulindependent diabetes mellitus (NIDDM) have clinical neuropathy at the time of diagnosis and this rate increases to 50% among patients who have had diabetes for 25 years. [2] Various screening modalities for diabetic neuropathy include recording of symptoms or signs, nerve conduction studies, quantitative sensory testing, and autonomic testing. [3] Quantitative assessment of vibration perception threshold (VPT) is a widely applied tool in the screening for, and staging of, diabetic sensory neuropathy, particularly in epidemiological studies.…”

Improvement of Cardiovascular Autonomic Reflexes after Amelioration of Metabolic Control in Insulin-Dependent Diabetic Subjects with Severe Autonomic Neuropathy

“…Recently many reports have related metabolic control to diabetic neuropathy (Pirart 1978;Graf, Halter, Halar and Porte Jr. 1979;Pietri, Ehle and Raskin 1980;Porte Jr., Halter, Pfeifer and Halar 1981;Graf, Halter, Pfeifer, Halar, Brozovich and Porte Jr. 1981). Moreover, these reports have regarded only diabetic peripheral neuropathy, showing either an inverse correlation between metabolic parameters and nerve conduction velocity {Graf, Halter, Halar and Porte Jr. 1979), or an increase in nerve conduction velocity after the improvement of glycemic control (Pietri, Ehle and Raskin 1980;Porte Jr., Graf Halter, Pfeifer and Halar 1981;Graf, Halter, Pfeifer, Halar, Brozovich and Porte Jr. 1981 Until now no data exist on the influence of the metabolic control and diabetic autonomic neuropathy, even though a common "metabolic" pathogenesis is also supposed for this diabetic complication (Clements and Bell 1982).…”