September 8, 2003
Complications
Question from Wales, Great Britain:
I live with my partner, who has had type 1 diabetes for 33 years. I am aware of the complications that people with diabetes can suffer, and luckily my partner is currently pretty much free from them. He controls his diabetes well although does sometimes have problems with hypoglycemia in attempt to keep his blood sugar control tight.
However, I wasn’t aware until very recently that his life expectancy is so significantly shorter than a person without diabetes. I read that a person with type 1 diabetes has a life expectancy, on average, of greater than 20 years less than someone without it. I am sure he is unaware of this, although he is aware of the possible complications. This has come as a shock, I do not know whether I should tell him what I have read and am worried.
He has a good diet (low fat, fruit and vegetables, etc.), exercises, doesn’t smoke, and is not overweight. His blood pressure and cholesterol levels are good. However, given the length of time he has had diabetes, is it inevitable that he will develop complications sometime in the future and die prematurely?
Answer:
Please do not become alarmed. First, your friend has already beaten the odds of developing chronic renal failure. After having type 1 diabetes for a duration of over thirty years, he is unlikely to have kidney involvement from his diabetes that would lead to chronic renal failure, dialysis, and an increased risk of death as a result of this problem. The truth is that if we was at risk for this problem, he would have developed some evidence of it by now.
Second, I am hesitant to believe there is that much discrepancy in life expectancy if current standards for therapy were consistently adhered to. Many patients previously developed blindness, amputations, and heart disease because of poor glucose control, poor treatment alternatives, and lack of availability of transplantation. I hope everyone realizes that people do not have to eventually end up with all the severe complications of diabetes. For those that do have complications, I also think there are better therapies than previously existed. In the end, you can only change the things you can change. Hang in there.
JTL
