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May 31, 2006

Complications

Question from Elkins, West Virginia, USA:

Since normal blood sugars range from 70 to 110 mg/dl [3.9 to 6.1 mmol/L] in non-diabetics, when does damage occur in diabetics? Is it as soon as it reaches 110 mg/dl [6.1 mmol/L] and up? Does it take awhile for the damage to occur? If blood sugars go too high in diabetics and you correct with more insulin, are you preventing any damage? How long does the blood sugar need to remain high before damage begins? Have there been any studies on this?

Answer:

There is no magic formula for when and how high blood sugar causes damage. We know that any higher blood glucose levels cause damage and the longer the blood sugar stays elevated, the more likely the damage. There is also some genetic susceptibility at work so that some are more resistant to such damage while others more susceptible. Factors such as weight, lipid levels, and blood pressure are important to know about just as history of heart disease, stroke, circulatory problems give a clue to who may be more or less susceptible. We even know that even high-normal values (low 100s mg/dl [5.6 to 6.7 mmol/L]) for blood sugars are associated with more heart disease, for instance. So, there is no safe zone. Low normal is better than high normal, just as an A1c of 6.0% is high normal but also associated with more heart disease, etc. versus 7.0% vs 8.0% etc. The higher the blood sugar, the higher the A1c and the longer duration, the worse. The balance with blood glucose control always has to be taken into account versus how much and how severe is the hypoglycemia.

SB