MARK V. SHEFFIELD, M.D.
To the editor: Gwinup (1) is rightly skeptical about drawing premature conclusions from the many prospective trials of the relation of microvascular complications of diabetes mellitus and glycemic control. Data from most large metabolic studies have accumulated over only the past 5 years, and conclusions, especially regarding pathogenesis of specific complications, are preliminary. Further confounding interpretation is a possible genetic predisposition for microvascular disease, especially retinopathy, in patients with the HLA-DR4 antigen.
It is of paramount importance, however, to define and recognize the scope of the underlying disease. If treatment merely depended on controlling blood sugar, diabetes would be a
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SHEFFIELD MV. Microvascular Complications of Diabetes Mellitus and Glycemic Control. Ann Intern Med. 1987;106:638-639. doi: 10.7326/0003-4819-106-4-638
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Published: Ann Intern Med. 1987;106(4):638-639.
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