Diabetes Mellitus and Hyperlipidemias

Abstract

The one generally accepted definition of diabetes mellitus is hyperglycemia inappropriate to the existing environmental and nutritional state. However, this symptom is only one of many endocrine and metabolic alterations present inclinically overtdiabetes, among which disturbances in lipid metabolism are most important. Perhaps the oldest notion of the associated appearance of diabetes mellitus and hyperlipemia is, according to a quotation by Eggstein, a statement of Marietin 1799 (22), and in 1917 Joslin (18) stated: “with an excess of fat diabetes begins and from anexcess of fat diabetics die.” In the earlier part of this century most authors apparently agreed that the extent of hyperlipemia depended largely on the severity of active diabetic symptoms and that the blood-lipid concentration represented the most reliable prognostic criterion for the diabetic patient (6,18). This was contradicted, however, by several authors and in Germany among others by Katsch (19), who in 1938 expressed the view that the extent of disturbance of lipid metabolism was not generally related to the severity of diabetes, although in the mean blood lipids tended to rise with acute diabetic decompensation and to fall again with recompensation. The moderately to strongly elevated blood-lipid concentration in well-adjusted diabetics was judged by him torepresent a personal characteristic of the individual patient. Katsch and Krainick (19) already distinguished the reversible hyperlipemia accompanying the acute diabetic decompensation from the irreversible, permanent hyperlipemia of well-adjusted diabetics. In 1955 Adlersberg and Wang (1) delineated the combined appearance of mild diabetes mellitus and severe idiopathic hyperlipemia as a distinct syndrome, which has previously been noted by Thannhauser (36) and therefore is referred to by some as the Thannhauser-Adlersberg or Adlersberg-Wang syndrome and by others as the “diabetic-hyperlipemic syndrome”(23).