The prognosis for diabetes.

Microvascular disease is the predominant manifestation of the juvenile-onset diabetic after the third decade of survival, while large vessel atheroma is the major problem in the long-term survival of the maturity-onset diabetic. From the experience of a diabetic-eye clinic, we would estimate that only about 3% of patients attending a hospital diabetic clinic would have a severe form of diabetic retinopathy which might need specialized ophthalmic photocoagulation treatment. The long-term visual prognosis for patients treated in this way remains under review. Among metabolic factors associated with vascular disease, a deficiency of HDL cholesterol may be important in the future prognosis of maturity-onset diabetes.