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October 2, 1967


JAMA. 1967;202(1):56. doi:10.1001/jama.1967.03130140114022

The characteristic small-vessel changes so often seen in diabetes mellitus seem to be an integral part of this disease. Atherosclerosis of the larger vessels, however, may not be so intimately related. Barring the possibility that atheromatous deposits are an indirect result of arterial-wall ischemia caused by diabetic angiopathy of the vasa vasorum, the relationship between diabetes and atherosclerosis would appear to be merely a predisposition. Yet so marked is this susceptibility that it has become a major preoccupation with many investigators and a source of much speculation.

A widely held view for a long time was that the high serum cholesterol attributable to the high-fat diabetic diet of years past constituted the bond between diabetes and atherosclerosis. The absence of consistent serum cholesterol elevation, as well as the failure of the subsequently fashionable high-carbohydrate diet to prevent atheromatosis discredited this theory. With the spotlight currently shifted from cholesterol to triglycerides,