INCIDENCE OF HYPERTENSION, ALBUMINURIA, DIABETIC RETINOPATHY AND CATARACT IN DIABETIC PATIENTS

Abstract

During the period 1950 to 1954, 145 patients with diabetes mellitus were admitted to the Medical Clinic of Prof. Kurokawa of the Tohoku University Hospital. In this report, the complication of hypertension, albuminuria, retinopathy and cataract was observed statistically. Our diabetic patients were classified in two groups; one group is the patients whose diabetic symptoms could be controlled by our standard therapeutic diet alone (I type diabetes mellitus), and the other the patients controlled by standard diet accompanied with insulin (II type diabetes mellitus).The incidence of hypertension in our diabetic patients was 31.0 per cent. This incidence is far higher than that in 1000 non-diabetic out-patients during the same period. The incidences of hypertension in diabetic patients of 4 and 5 decades were compared with those in non-diabetic patients of the same decades and no difference in incidence of hypertension was found between these two groups. Hence, the difference in incidence of hypertension between diabetic and non-diabetic patients is not an essential one, but an apparent one due to the different age distribution in these two patients groups. No significant difference was found in the sex, the type and the duration of diabetes. With increasing severity of hypertension, there was an increase in the incidence of albuminuria, diabetic retinopathy and cataract in those patients with hypertension. There was no significant difference in incidence of inheritance of apoplexy and diabetes between these two groups.The incidence of albuminuria was 26.8 per cent and twenty per cent of our diabetics showed more than 2 plus albuminuria. With increasing duration of diabetes there was an increase in the incidence of albuminuria. Albuminuria was more frequent in II type diabetes and in high decades.The incidence of diabetic retinopathy was 23.6 per cent and that of diabetic cataract was 16.5 per cent. Both ocular complications were more frequent in females, in II type diabetes and in patients with longer duration of diabetes. Relatively low incidence of retinopathy was found in patients of 4 and 5 decades.Kimmelstiel-Wilson syndrome was observed in 8.6 per cent of our diabetics. This syndrome was more frequent in II type diabetics.The urine 17-ketosteroid excretion was increased in Kimmelstiel-Wilson syndrome, but normal in patients with diabetic retinopathy.