Diabetes mellitus and diabetic retinitis; factors influencing regulation.

Fifty patients with diabetes of long duration -20 to 35 years-who followed regimens to control the disease with the greatest fidelity did not have visual complaints; retinal abnormalities were minimal and hypertension, albuminuria and renal impairment were absent. Diabetes is a disease of total metabolism and not related solely to carbohydrate. In the preinsulin era many facts concerned in the regulation of diabetes were established scientifically-facts such as that regulation of the body mass and control of obesity are important, that damage is caused by over-restriction of carbohydrate intake, and that hyperglycemia activates diabetes. Many failures in the treatment today are owing to insufficient attention to these basic factors. Good control requires an effort to keep hyperglycemia and glycosuria at a minimum.