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Vasculitis in Maturity-Onset Diabetes Mellitus

David W. White, MD
JAMA. 1976;236(19):2171. doi:10.1001/jama.1976.03270200011002.
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To the Editor.—  In response to Dr Barner's commentary on vasculitis in maturity-onset diabetes mellitus (235: 2495, 1976), I believe most ophthalmologists will agree with me that it is impossible to make any sweeping generalizations regarding microangiopathy in patients with adult-onset diabetes. We find a wide spectrum in these cases, extending from no evidence of vascular disease to the other end of the spectrum, exemplified by florid diabetic retinopathy with innumerable microaneurysms, neovascularization in the anterior and posterior segments of the eye, retinal hemorrhages, and vitreous hemorrhages with all the sequelae that eventually lead to blindness. On the other hand, we also see patients with "brittle" juvenile diabetes mellitus in whom no severe microangiopathy develops during a normal life span.Dr Barner states that the cardiovascular surgeon "recognizes that diabetic microangiopathy does not exist to the extent that it contraindicates operation or a good result thereof," referring to the patients


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