[Diabetes mellitus and cardiovascular system diseases in middle age]

The data on the interrelationship of diabetes mellitus and atherosclerosis are shown. To characterize the frequency of cardiovascular lesions and their different character according to age in patients with diabetes, the results of clinical analysis of 2,540 patients and the findings of thorough clinical and laboratory examination of 1,154 individuals, 20.1% of whom were over 60, are presented. The high frequency of angiopathies (84.6%) confirms the "atherogenics" effect of diabetes mellitus. The age differences consist in the predominance of organic lesions among elderly persons. The frequent occurrence of a disturbed glucose tolerance test and the development of diabetes mellitus in these patients are evidence of the "diabetogenic" effect of atherosclerosis. Some hormonal and metabolic mechanisms are investigated for the interpretation of the pathogenesis of cardiovascular lesions in diabetes. The contribution of contrainsular hormones (somatotrophic hormone, adrenal hormones) and hyperlipidemia to the development of diabetic angiopathies is substantiated. The difference between diabetic macroangiopathies and atherosclerosis in nondiabetic individuals is discussed on the strength of the results of electron microscopy of the mucle capillaries. It is concluded that these two diseases, which are widely encountered among elderly individuals, have hormonal, metabolic, and genetic developmental mechanisms in common.