Thayer lecture. Diabetes mellitus: a brief overview

Thus to summarize, there are a number of experimental and critical observations which all tend to support the contention that the hyperglycemia and perhaps to a lesser degree, the insulin deficiency, contribute significantly to the atherosclerosis and more directly initiate and expidite the microangiopathy and neurological abnormalities noted in diabetes. There is little evidence to suggest that the microangiopathy has any direct genetic relationship except via the beta cell and the resulting insulin deficiency.