Joseph R.

Kraft, MD, MS, FCAP

jrkraftmd@gmail.com
________________________________________________________________________________________________
20 April 2012 - 30 April 2014
Template letter sent to the global medical community.
Dear Doctor
Publications past, present and future that fail to identify hyperinsulinemia as the
vascular pathogenesis of the anatomic pathology of diabetes are incomplete.
The Task Force on diabetes, prediabetes and cardiovascular diseases of The European
Society of Cardiology and developed in collaboration with The European Association for
The Study of Diabetes published their guidelines in The European Heart Journal of The
European Society of Cardiology, August 30, 2013. The 546 references in the ESC and
EASD guidelines fail to identify the vascular autopsy pathology of diabetes,
hyperinsulinemia the sine qua non of type 2 diabetes, and hypoinsulinemia the sine qua
non of type 1 diabetes.
The clinical application of the very earliest laboratory diagnosis of diabetes has been
limited. The oral glucose tolerance with insulin assay is the very earliest laboratory
diagnosis of type 1 and type 2 diabetes (1975). Credit must be given to Yalow and
Berson who pioneered the behavior of iodine-131 labeled insulin in the 1950s. Their
study led to the development of a radioimmunoassay for plasma insulin. The
demonstration of insulin in their diabetic patients by oral glucose tolerance with insulin
assay was unprecedented (1960). Definitive classification followed (1975).
Based upon my several thousand autopsy examinations, the pathology of diabetes is
vascular. The initial manifestation of the pathology of diabetes is athero-arteriosclerosis.
The pathology begins when blood sugars and glycated hemoglobin are normal. The
pathology of diabetes has been mislabeled risk factors. With normal blood sugars,
anyone with risk factors are diabetic. The insulin assay with oral glucose tolerance will
confirm the diabetes diagnosis.

Dr. Stouts research of the 1970s identified hyperinsulinemia as a primary cause

affecting the endothelium, the innermost single cellular layer of arteries and capillaries.
The distribution of capillaries throughout the body accounts for the microangiopathy of
the retina, the glomeruli of the kidney, the interstitial myocardium of the heart and the
neurootology of the central and peripheral nervous system. The goal of my research is
to awaken The International Medical Community that diabetes is a vascular disease.

Hyperglycemia unfortunately for many remains the very earliest diagnosis of diabetes.
The very earliest laboratory diagnosis is not by glycated hemoglobin nor by fasting blood
glucose. The normal glycated hemoglobin like the normal fasting glucose do not
exclude diabetes. Glycated hemoglobin diagnose or monitor hyperglycemia late phase
of type 2 diabetes. The very earliest laboratory diagnosis is by oral glucose tolerance
with insulin assay.
Enclosed for your perusal is the 2011 edition of Diabetes Epidemic and You. This book
challenges medical educators to utilize the earliest laboratory diagnosis. Physician
leadership is paramount for this to succeed. To awaken international interest, Diabetes
Epidemic and You has been sent to the Dean and select faculty of 100+ medical schools
throughout the world.
The oral glucose tolerance with insulin assay is an empirical laboratory procedure. It is
multiple biochemical biopsies that are dynamic. Results will be one of five
glucose/insulin patterns irrespective of origin. Pattern I identifies euinsulinemia (see
page 48). Pattern II, III, and IV diagnose hyperinsulinemia, type 2 diabetes. Pattern V
identifies hypoinsulinemia, type 1 diabetes. Analytical analysis with deductive reasoning
will affirm the earliest diagnosis and treatment of diabetes.
The 14,383 oral glucose tolerances with insulin assay with ages ranging from 3 to 91
years have substantiated the very earliest laboratory diagnosis of diabetes. This
research is statistically affirmed and unequalled in medical literature. The very earliest
laboratory diagnosis with treatment will abort the worldwide epidemic of diabetes,
which continues to impound national and international medicine.
Will The American Diabetes Association, The European Association for The Study of
Diabetes and The European Society of Cardiology ever endorse the very earliest
laboratory diagnosis and treatment of diabetes as identified in this text? Of course they
will when the medical communities and public demand the highest standard.

Respectfully yours,
Joseph R. Kraft, MD, MS, FCAP