Microangiopathy in young diabetic men

Summary Skin punch biopsy was performed on 38 diabetic men with varying durations of diabetes and 17 non-diabetic men, all between the ages of 17–45 years. — Light microscopical changes in venules, capillaries, and arterioles without an internal elastic lamina were arbitrarily graded twice by two of us independently with no access to clinical data. A grading system with 5 degrees was used for assessing the wall thickness. — The most characteristic lesion was thickening of the walls of the blood vessels. Significant thickening was noted in 14 diabetics and 1 control. No definite changes in the endothelial cells were demonstrated. The nuclei of the pericytes often seemed conspicuous, comparatively large and hyperchromatic. Positive significant correlation was shown between the wall thickness and this pericyte change in the diabetics, but not in the controls. — The wall thickness was significantly and positively correlated with the age of the diabetics, duration of diabetes and diastolic blood pressure. Multivariate correlation, however, revealed a significant correlation between the wall thickness and the duration of diabetes, and a tendency to correlation with age. This presumably means that the correlation with diastolic blood pressure, and probably part of the correlation with age, can be accounted for by the dependence of the wall thickness on the duration of diabetes. In the control group no correlation was shown between the wall thickness and age, systolic blood pressure or diastolic blood pressure. Positive significant correlation independent of the duration was demonstrated between wall thickness and retinopathy. — The investigation indicates that the wall thickness is increasing with the duration of diabetes, and that the pericytes may be involved in the development of dermal capillary and venule lesions in diabetes. It is suggested that skin biopsy may serve as an examination, supplementary to ophthalmoscopy, in the early diagnosis of diabetic microangiopathy.Presented in part at the Annual Meeting of the Swedish Medical Society, Stockholm 1965 (Säve-Söderbergh et al., 1966)