Diabetes Epidemic & You by Joseph R. Kraft

Author:Joseph R. Kraft
Language: eng
Format: azw3, epub
Tags: Medical, Endocrinology & Metabolism, General
ISBN: 9781425168094
Publisher: Trafford Publishing
Published: 2008-05-06T22:00:00+00:00

Pathology of type 2 diabetes ^ Pathology of hyperinsulinemia

Up to 21 percent of patients with type 2 diabetes have retinopathy at the time of their first diagnosis of diabetes. (B. S. Fong, L. Aiello, T. W. Gardener, G. L. King, G. Blankenship, et al. 2003. Diabetes retinopathy. Diabetes Care 26, Suppl 1.) Recent data shows that retinopathy (blood vessel changes in the retina of the eye) begins to develop at least seven years before the clinical diagnosis of type 2 diabetes.

The onset of type 2 diabetes probably occurs at least 12 years before the clinical diagnosis. (Harris, M. I. 1993. Undiagnosed NIDDM: Clinical and public health issues. Diabetes Care 16:642-52.)

In 1972, Siperstein and associates reported electron-microscopic findings of basement membrane hypertrophy (thickening of the endothelium of renal glomeruli) present in 98.6 percent of 51 overt diabetic patients. This was 50 of 51, with the one being at the upper limit of their normal. They had noted that this finding of diabetic microangiopathy preceded the manifestation of diabetes mellitus by months or years. Even more remarkable was their finding that 50 percent of genetic prediabetics tested demonstrated basement membrane hypertrophy prior to the onset of detectable carbohydrate abnormalities. Their “genetic” prediabetics were those whose parents were diabetics. This important basic impact of the Siperstein group—finding definitive histopathology by electron microscopy prior to detectable carbohydrate abnormalities—went unrecognized. (Siperstein, M. S., R. H. Unger, and L. L. Madison. “Further Electron Microscopic Studies of Diabetic Microangiopathy.” In R. H. Camerini-Davalos and H. S. Cole, eds. Early Diabetes: Advances in Metabolic Disorders, Suppl 1. (New York: Academic Press, 1972), 261-71. Worldwide medicine at the time of Siperstein and even today is still harnessed to the identification of diabetes and prediabe-tes mainly by the fasting blood glucose. (American Diabetes Association Clinical Practice Recommendations, Diabetes Care 30 (2007) Suppl 1.)

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