二次性糖尿病に合併した進行性の糖尿病性網膜症の1例

Clinical Studies in a Case of Progressive Diabetic Retinopathy

I．はじめに

　糖尿病性網膜症（以下網膜症と略す）の予防，治療に全身治療，特に血糖のコントロールが大切なことは，すでに福田が何度か強調したところであるが，過剰な治療，すなわち低血糖の反復も網膜症に悪影響を与えるものであることが，徳田，勝瀬らによつて報告されている。

　われわれも最近このような全身療法の不適切なことが，網膜症の発症，進行を促進したと思われる二次性糖尿病の1症例を経験し，その全経過を追跡し得たのでここに報告したい。

A case of Kimmelstiel-Wilson's syndrome is presented covering the last two years of the patient. The patient, a male of 48 years of age, was suffering from diabetes mellitus with progressive retinopathy and severe nephropathy as complications. The retinal and renal condi-tions seemed to be accelerated by hypoglycaemia and hypertension, because the retinopathy and nephropathy always progressed after hypogly-caemia or hypertension developed.

During autopsy, the diabetes mellitus of this case was identified as pancreatic diabetes, as a stone was present in the pancreatic duct and the pancreas was reduced to fibrous atrophy.