September 4, 2001
Complications
Question from the United Kingdom:
I’ve had type 1 diabetes for 20 years, and for the past three years, I’ve worked harder at control resulting in a 7% hemoglobin A1c. Previously, I paid very little attention to my diabetes, and even though I don’t know what my A1c actually was, it was it was probably over 10%. Will all those years of poor control inevitably catch up with me? Will my risk of complications decrease each year I maintain good control?
Answer:
Each year or given period of time of good control will substantially decrease your risk for future complications even though you were in poor control for so many years before. This concept has recently been reinforced in a long-term study of people with diabetes and advanced chronic complications who have undergone pancreas transplant. Some years after transplant, renal and retinal complications progressively got better.
In light of this, my advice would be, besides maintaining the best metabolic control, also periodically check blood pressure and blood lipids.
MS
