I have had type�1 diabetes for 13 years, have been on an insulin pump for nine years with hemoglobin A1c’s of 4.8-6.0%, and my three year old son was recently put on multiple injection therapy. I have never worried about complications every day, but, since my son has been diagnosed, I worry about them all the time. I have read lots of books regarding complications, some of which say, “you have a 50 percent of developing eye, nerve damage after 30 years,” and some cite other percentages.

I know that the DCCT study, says tight control can reduce complications, but have there been any more studies just looking at the actual complication rates for type 1 individuals with tight control? I do not think it fair to lump people with controlled diabetes and people with uncontrolled diabetes together to get the percentages for complications. What studies are currently looking at this? Are any pump companies involved with studies?

Statistics can tell you almost anything, but you are correct. Most of the things written about diabetes take into account those many people who have not been taught or do not choose to take care of themselves as well as those who do an excellent job.

The DCCT is the best and longest study involving teens and young adults over an average of six to seven years in what is called a prospective fashion and randomized clinical trial. So, the DCCT provides the best information about what happens to a group of people who care for themselves. There are no comparable data on very young children — only our clinical judgment that the same would apply to all who have diabetes of any age.

There are also other factors such as smoking, family predisposition to diseases, hypertension, lipid problems, heart attacks and circulation problems, etc. All these factors matter, of course, but glucose control is still a key ingredient.

So, keep up the good work. Keep doing the same good work for your child and, without any promises, it is likely that you and your child will both be healthier in the years to come. Also remember that current treatment is never perfect, but there is always a chance to respond and improve.

SB