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Two hundred and eight long-term diabetics from the diabetic population of one district were examined thoroughly by physicians of the several special branches and compared with a control group consisting of biostatic twins with a healthy metabolism. Case control was performed for 5 years. The frequent absence of pathological findings in the coronary, peripheric and cerebral regions as well as a significantly high percentage of standard weight and underweight were found to be characteristic signs in that patients who survived their diabetes for several tens of years. Five years after the first registration, 68 long-term diabetics and 23 subjects of the control group had been died. However, the excess mortality does not surpass the mortality of subjects diseased for a short period. Besides the age and the duration of the manifestation, the survival rate was found to be dependent on the degree of the micro- and macroangiopathies, hypertension and over-weight. On the other hand, the duration of the diabetes and the metabolic condition did not exert any perceptible influence.

Within a clinical epidemiological investigation 168 diabetics were examined multidisciplinarily who survived the beginning of their disease by at least 20 years. The qualitative proof of protein in the urine was regarded as criterion for the presence of a diabetic nephropathy. 29% of the long-term diabetics showed a proteinuria. In a control group of probands with healthy metabolism, however, only 2.5% proteinurias were found. Statistically ascertained correlations were the results in cases of proteinuria and retinopathy (microangio-pathy). Particularly close were the relations of proteinuria to arteriolosclerosis (macroangiopathy). There were no relations between the proof of a proteinuria and the quality of the control of the carbohydrate metabolism which was pursued during decades.

When the conventional ECG after resting was used for establishing frequency and degree of severity of the ischaemic heart disease the stronger cardiac endangering of the longterm diabetic could be ascertained only from residues of an infarction (pathologic Q- and QS-types). With regard to all electrocardiographic criteria of the ischaemic heart disease according to the WHO-definition concerning the coronary risk a dependence on age, over-weight and increase of blood pressure was found without essential differences between the two groups. According to data in literature ischaemic reactions in diabetics are significantly more frequently to be expected only by inclusion of the electrocardiogram after work. Among the group of diabetics the frequency of the ischaemic heart disease increased with the duration of the disease. In contrast to retinopathy there was no dependence on the quality of the metabolic condition.

On the basis of two observations is reported on the apparently rare appearance of coronary T-waves in the ECG after acute talinolol intoxication as well as after permanent medication of propranolol.