当科で糖尿病の治療開始後5年間にわたる糖尿病性網膜症の推移を検討した.5年間におけるScottIV以上の重症網膜症への進展は初回眼底所見Scott 0では0.4%, Scott Iaでは3.1%, Scott IIでは10.0%, Scott III aでは23.8%であった.糖尿病の治療開始後1年毎の5年間にわたる網膜症の発症率, 進展率は治療開始後1年間でもっとも高率であった.治療開始後1年間における網膜症の発症率, 進展率はその間のニントロール不良群で有意に高率であった.またコントロール良群でも, コントロール不良群でも初診時空腹時血糖値180mg/dl以上のもので, 初診時空腹時血糖値179mg/dl以下のものにくらべ, 有意に高率であった.観察期間の5年間に網膜症の著明な進展を示した22例における著明な進展を示した時期は22例中10例 (45.5%) が治療開始後1年以内であり, この10例中8例では初診時までの罹病期間が5年未満であった.
Twenty-nine unrelated Japanese patients with insulin dependent diabetes mellitus with juvenileonset (JOD) were HLA typed with special reference to family history. The following results were obtained. 1) The frequency of BJW 22-2, a Japanese specific subclass of BW 22, was significantly (x2y= 20.7) increased in JOD, as a whole, compared with the control group. 2) The frequency of B 5 was significantly (x2=16.4) decreased in JOD as a whole. 3) Of twenty-nine JOD patients, twelve had a family history of maturity-onset diabetes (MOD), and seventeen had no apparent family history of diabetes mellitus. Among JOD patients with a positive family history of MOD, two with an insidious onset and one with a history of obesity before the onset were found. The incidence of ketonuria and emaciation was less frequent in this group than in the group without a positive family history of MOD. 4) In the group with a positive family history no difference in phenotype frequencies of HLA was found when compared with a control. 5) In the group without a family history, the frequency of BJW 22-2 was significantly (x2=19.7) increased and no patient had B 5. The frequency of a positive response in the leucocyte migration inhibition test, using mitochondrial fraction of islet cell as an antigen, was significantly higher in this group than in the group with a family history. These results suggest a genetical as well as clinical heterogeneity of so-called JOD.