Ophthalmological examination of 148 Japanese diabetic patients, ranging from 19 to 78 years of age, showed that 45 cases had cataracts (30.4%), the incidence of cataracts for males and females being 13/73 (17.8%), and 32/75 (42.7%), respectively. The difference of the incidence between male and female patients is statistically significant (p<0.005). In young diabetic patients under the age of 29 the difference of the incidence of diabetic cataracts between both sexes is remarkable. All of the 6 males had no cataracts and 7 of 11 females had cataracts (p<0.05). Three of these 7 females were found to have had cataracts already when they were diagnosed as having diabetes and, in the other 4, lens opacities appeared within two years after the diagnosis of diabetes. Therefore, diabetic cataracts seem to occur in a short duration of diabetes and to develop rapidly in young female diabetic patients. As to the severity of diabetes (FBS before treatment), state of metabolic control, method for the treatment of diabetes and grade of diabetic retinopathy, no marked difference were observed between young diabetics with and without cataracts. The facts deserve, however, special mention that all of the 7 patients with cataracts developed diabetes after their ages of adolescence, while half of those without cataracts had been suffering from diabetes since childhood, and that the most of those with cataracts complain of disturbances of menstruation such as amenorrhea or oligomenorrhea. These facts suggest that endocrine environment including sex hormones may play a role for the pathogenesis of diabetic cataracts, possibly through the sorbitol pathway activity, the permeability of the capsule or the regenerative capacity of the lens.
