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November 4, 2002

Complications

Question from Wilkes-Barre, Pennsylvania, USA:

If you have a lower A1c, can you delay complications? If it stays low, can you put off complications? Has anyone ever looked at this? Are there any studies on people with type 1 diabetes? Is it just a matter of time that complications will occur?

Answer:

Since it is almost impossible to maintain hemoglobin A1c in the normal range, and since studies like the DCCT have not been carried out long enough, it is impossible to answer your question. There have been reports dating as far back as the early 1970’s reporting individuals with type 1 diabetes for over 40 years with no complications (before home meters, before insulin pumps, before purer, newer insulins and before A1c measurements). So there definitely are people who seem never to develop complications (though for someone who gets diabetes as a child, even 40 years without complications isn’t enough). I am not aware of published reports of people who have had diabetes even longer, but there certainly are individuals with no complications who have had diabetes for more than 40 years. So, try to get the best control possible and enjoy life!

TGL