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Diabetoiogia (1991) 34:67-73 0012186X9100028W Diabetologia 9 Springer-Verlag 1991 Review Georges Tchobroutsky H6tel-Dieu~ Universitd Pierre et Marie Curie, Paris, France Most, if not all, diabetologists are convinced, on the basis of indirect evidence which has been accumulated over the decades that the microangiopathic and neurological complications of diabetes are primarily dependent on the duration and extent of chronic hyperglycaemia [1-5]. Hyperglycaemia is the necessary factor in the development of these complications even if other, secondary factors, sometimes responsive to treatment, such as blood pressure levels, smoking, protein intake, with or without genetic predisposition, may modulate its expression [6]. However, as emphasized by Krolewski et al. [7] and Mogensen [8] it is the degree (and duration) of hyperglycaemia which remains the most important aetiological factor in predisposed groups of patients. Before we are able to detect with accuracy on an individual basis the subjects at risk from diabetic complications, blood glucose control will be of paramount importance because, as emphasized by Rothman [9]: "Identification of all the components of a given sufficientcause is unnecessary for prevention, in that blocking the causal role of but one component of a sufficient cause renders the joint action of the other components insufficient and
Diabetologia – Springer Journals
Published: Feb 1, 1991
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