The long-term microvascular, neurologic and macrovascular complications of insulin-dependent (IDDM) and non-insulin dependent diabetes mellitus (NIDDM) cause major morbidity and mortality. (1) Despite major advances in the treatment of diabetic retinopathy with photocoagulation (2,3) and vitrectomy (4), it remains the major cause of new onset blindness in adults in the U.S. (1) Diabetic nephropathy is the most common cause of end-stage renal disease in adults. (5) Diabetes increases the risk of amputation by more than forty-fold compared with the non-diabetic population and accounts for more amputations in the U.S. than any other cuase. (1) Finally, the major cause of mortality in diabetes is cardiovascular disease. Diabetes is associated with a two- to seven-fold increse in cardiac and cerebral vascular disease (6-8). The estimated cost of these complications in the aggregate was in excess of 20 billion dollars per year in 1987. (9)
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