THE PATHOGENESIS of diabetic glomerulosclerosis has not as yet been completely explained. The lesion has rarely been reported in association with diabetes mellitus secondary to pancreatic damage or removal of that organ. This rarity has been cited as evidence that the vascular lesions of diabetes mellitus may be genetically determined. The following case report describes the development of nodular diabetic glomerulosclerosis of the Kimmelstiel-Wilson type in a patient with diabetes mellitus apparently due to chronic pancreatitis.
Report of a Case
Patient R. C., an unemployed painter, was first seen in the outpatient department of Hennepin County General Hospital in December 1954. The patient, then 43 years old and married but childless, had consulted a doctor five months previously because of a recent 50-lb (22.7-kg) weight loss. A diagnosis of diabetes mellitus was established, and the patient was advised to take 30 units of isophane insulin suspension (NPH) insulin daily.