My 19-year-old son has had type 1 for almost three years. His control on an insulin pump has been superb right from the start. His A1c has never been higher than 5.7%, except when he was first diagnosed, of course. He had his first visit with an adult endocrinologist, transitioning from a pediatric endocrinologist. The adult endocrinologist told my son that if he can continue to maintain this excellent control, he will NEVER have any complications. My only wish is that this message goes from his mouth to God’s ears. Do you agree with the doctor’s statement? Does it become tougher to maintain excellent control the longer one has this disease?

As a person who also works in a young adult transition clinic with patients ages 15 to 25, it is uncommon to have that many patients with good control. It is just plain hard to get people to monitor their blood sugars in a timely fashion and make the changes necessary to keep up good control. One thing that a person that has recently been diagnosed with type 1 diabetes has going for them is that they still may produce some endogenous insulin. Over time, this goes away. If your son maintains the good control he has exhibited so far, he will go a long way to minimizing his risk for developing any diabetes-related complications. There are no guarantees, but it would be very uncommon to see someone with complications with those levels of A1c.

JTL