I have had type 2 diabetes for less than a year, my three-month blood test is 6.1%, and the only time my blood sugar reads high is in the mornings (130 mg/dl [7.2 mmol/L]). Before and after meals, it’s well inside the safe levels. These readings all came before any special diet or exercise program. If my blood sugar readings remain at these levels, will I experience diabetes related health problems? Lord knows we all have enough health worries without adding on what may be insignificant. My doctors don’t seem to have an answer to this question.

In medicine, as in life, I think most of us will agree that we can “never say never”, but based on your hemoglobin A1c and your blood glucose averages throughout the day, your diabetes is currently in excellent control!

Your diabetes has appears to be at a very early stage in the disease process. This fact gives you the advantage and the opportunity to make appropriate lifestyle modifications, including diet and exercise, in an effort to keep those numbers where they are now. Should you be worried about complications so much so that it affects your life? No, but should you ignore the early warning accompanying your recent diagnosis? Also a no.

Unfortunately, type�2 diabetes is a progressive disorder, particularly when the factors that enhance it (excessive weight, insulin resistance) are not addressed. It is important to remember that both insulin resistance and the prevalence of type 2 diabetes increase as we age. Also important is the knowledge that the risk factors for cardiovascular disease (hypertension, lipid disorders, etc) increase in prevalence in both diabetes and with advancing age. Prevention is key and awareness is the first step.

Knowing that you have a tendency towards elevated blood sugars should inspire you to watch your carbohydrate intake, exercise regularly, manage your weight and your cardiovascular risk factors, and test your blood sugars so that you can assist your physician in identifying the need for medication should that arise. You should also be aware that there are other medications (such as thiazide diuretics often prescribed for blood pressure or excess fluid) that may elevate fasting blood sugars in people with a tendency towards diabetes.

You may wish to speak with your doctor or pharmacist regarding this. If you can keep your blood sugar levels where they are now by optimizing these issues, then we know from the DCCT and the UKPDS studies among others, you will minimize the risk of developing complications.

DMW