Question from Woodstock, New York, USA:

My 18 year old boyfriend has had diabetes for a decade, and after his mother died of cancer, he spiraled into self-destruction with glucose readings all over the map. Years have passed since that incident, and he still drinks and smokes both cigarettes and marijuana. Last week he almost went under when he had a reading of 30 mg/dl [1.7 mmol/L], and later that night he was almost at 600 mg/dl [33.3 mmol/L]. He’s trying to get himself under control, but, like with any chronic illness, he has difficulty with it. His feet are starting to peel, he’s seeing floaters in his vision, and his kidneys hurt. Despite all this, he just can’t get it under control. Honestly, with the irreparable damage done, has his life expectancy been shortened? It breaks my heart, but I need to know if this is the beginning of the end and what I can do because this tearing me apart too.