Diabetes and Vascular Disease

To the Editor: In the editorial exception taken by Siperstein et al.¹ to a previous editorial published in the Journal, an equation was made between capillary basement-membrane thickening and diabetic microangiopathy. We should like to point out that diabetic changes in small blood vessels are more extensive than just thickening of the capillary basement membrane. The relation between capillary basement-membrane thickening and microangiopathy deserves a clearer definition than was given in the editorial. Capillary basement-membrane thickening in diabetes has been studied most extensively in skeletal muscle, where it is regularly found to be increased in well established diabetes, except.