I am a 23 year old female and have had diabetes for 17 years. I have always been in good control with HbA1cs usually around 5-6%, occasionally in the low 7% range. I am very nervous about developing complications, particularly kidney problems. About two months ago, I had a 24-hour urine analysis, which was fine, and a negative retinal scan With this good news, I vowed never to have periods of high blood sugars again so that would not have to get so nervous every time I get back a test result. Then, this past month, my blood sugars have been having their way with me. No matter what I do, they were up to 300 mg/dl [16.7 mmol/L] at least once a day. I have been testing my blood sugar all the time, so it’s never high for more than a few hours at a time. Still, I am getting nervous all over again. I have things more under control now, but I’m wondering: can one month of bad blood sugar control cause the complications I’m so fearful of?

First, it sounds like you are working very hard on blood sugar control and have had very good results. The fact that you catch the blood sugars when they are elevated and work quickly to bring them down is an added bonus to your care and management. It may be that these high blood sugars minimally affect your hemoglobin A1c. It is the total area under the glucose control curve that determines the A1c. Put another way, you still may have a good test result because your control is good most of the time.

I sense a great deal of anxiety on your part with regard to your results. Diabetes is a chronic disease and requires and long-term strategy. That means having the right set of mind to address to any changes that occur in the future. I would think about why the blood sugars are in the 300s mg/dl [16.7 mmol/L] and have a proactive plan to prevent the rise (change dose, timing, carbohydrate counting).

The main thing is that you are doing a good job and giving yourself the best chance to have a healthy life. Keep up the good work.

JTL