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August 15, 2001

Complications, Tight Control

Question from Woonsocket, Rhode Island, USA:

I have had type 1 diabetes for 21 years and question a posted response which said, "It is true that the risk of complications to the eyes, kidneys, and nerves is directly related to blood sugar control." If that is true, then why, three months ago did I have a leaky blood vessel in my right eye which required need laser surgery when, for the past five years, my hemoglobin A1c's have all been under 7.2%? I can still see the blood in my eye. Could it be that some people who have diabetes are more prone to complications than others regardless of control? It just seems to me that some people get complications, and some people don't -- regardless of control.

Answer:

I am sorry to hear about your eye problems. Unfortunately, there is a small number of people with good control (10%) who develop eye disease, despite the good control. It may be that some of those people with eye disease and good control had bad control in the distant past and there is some remembered result from that. However, when looking at large populations, the trend holds true that those with the worst control over time have the greatest chance for developing microvascular complications, including retinopathy.

JTL