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Hemorrhagic Diabetic Retinitis; A Method of Treatment Based on the Elevation of Plasma Albumin by Diet

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Abstract

Serious vascular damage used to be considered a complication of diabetes mellitus; it is becoming more generally recognized that this damage is an integral part of the disease. Previously it was hoped that eradication of hyperglycemia with the aid of insulin would prevent what was considered the “complications” of the disease. The careful observation of patients receiving adequate control of glycosuria and hyperglycemia has led to an ever increasing suspicion that this is not sufficient to prevent progressive vascular degeneration. Such progressive vascular disease leads to the tremendous morbidity and high mortality associated with retinal damage, renal failure, coronary artery sclerosis, and gangrene of long standing diabetes mellitus.

With these facts in mind it has become apparent that a clearer understanding of the fundamental processes involved in the accompanying vascular disease is necessary before we can hope for the development of methods for their prevention. No clinical approach to the diabetic patient is complete, therefore, without a careful appraisal of his vascular status from time to time. In our patients a minimum requirement includes careful examination of the retina by an ophthalmologist, an evaluation of renal function, an estimate of any change in the peripheral vessels, determination of cardiac status, and frequently the taking of an electrocardiogram.

Up to the present time our chief interest in this regard has centered upon the vascular disease of the retina. Particular attention has been given to the study of alteration in plasma proteins which might be a contributing factor in the production of. . .


 

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