DIABETES AND ARTERIOSCLEROSIS IN YOUTH

To the Editor:—  A recent editorial entitled "Diabetes and Arteriosclerosis in Youth" (The Journal, Dec. 20,1947, p. 1074) appears to demand certain qualifications. The assertion that the degree of control of hyperglycemia and glycosuria with insulin is the principal factor determining whether vascular damage will occur in a patient with diabetes is definitely open to question. Henry Dolger concludes in a recent report on 200 cases studied over a period of twenty-five years (Clinical Evaluation of Vascular Damage in Diabetes Mellitus, The Journal, Aug. 16, 1947, p. 1289) that "present day treatment of diabetes has failed to avert the accelerated vascular damage, which is an associated phenomenon of the disease and not a complication." He found that in 50 per cent of his patients vascular damage developed after thirteen years regardless of age of onset, severity of diabetes or type of treatment used. His conclusion was that duration of. the