I have had diabetes treated with Glucovance a little over a year, and I have easily maintained my blood glucose levels around 95-129 mg/dl [5.3-7.2 mmol/L]. Is there any evidence that health problems associated with diabetes will develop even if I always am able to maintain good blood glucose levels? Will these potentially only be possible if my blood glucose levels exceed 200 mg/dl [11.1 mmol/L] for periods of time?

You bring up some good questions. First, I am glad your sugars are better. In terms of microvascular complications (eyes, kidney, nerve problems), the risk of developing these complications is directly related to level of control you have. If your control is good, you stand a much better time of avoiding these problems than if your control is bad.

I recommend you try to maintain a level control consistent with the best possible A1c. This would mean keeping blood sugars below 140 mg/dl [7.8 mmol/L] all the time. Keeping them below 200 mg/dl [11.1 mmol/L] is not tight control. The macrovascular complications are related to other things that may or may not be made totally better by the Glucovance.

For instance, people who have prediabetes, before they ever have type 2 diabetes, are at high-risk for developing heart attacks. People who have diabetes are considered to be at risk for another heart attack in a manner similar to a person who has already had a heart attack. So you see, there may be other factors about having diabetes that are not made better by just glucose control alone. That is why you have to watch your diet, get regular exercise, keep your lipids down, stop smoking, take aspirin, and have a regular cardiac stress test to prevent from having a heart attack or stroke.

JTL