Abstract
Though the histological glomerular lesions in diabetes mellitus appear in two distinct types, the diffuse and nodular, the former lacks pathognomonic features, and its differentiation from mild chronic glomerulonephritis has been practically impossible. A histometrical method was introduced into the present study to establish a diagnostic basis of slight diabetic nephropathy. The relative reduc-tion of mesangial nuclei per unit area of mesangial tissue was characteristic of diabetic glomerular lesions and was useful for separating diabetic from mild chronic glomerulonephritic lesions. This was due to hyaline thickening of the mesangial tissue in diabetics without nuclear proliferation.
Diabetic glomerular lesions were further quantitatively evaluated and correlated to a number of clinical symptoms. Positive correlation was confirmed between the grade of glomerular lesions and serum lipid levels. The correlation was regarded as of pathogenetic significance in the diffuse glomerular lesion.
The development of coarse nodular glomerular lesions was ascribed to mesangiolytic changes with subsequent plasmal infiltration into the mesangial tissue and capillary thrombosis. Locally accentuated hyaline deposits in the mesangial tissue occasionally simulated small nodular lesions, but they did not grow to typical large nodules without preceding mesangiolytic changes.
