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July 31, 2002

Complications

Question from Australia:

My 26 year old husband, who has had type 1 diabetes since he was two years old, keeps his blood sugar levels under control, and he has had rare hypo attacks. What is the likelihood of long term effects of diabetes (kidney problems, etc.)? Is the length of his life affected? Sorry to sound morbid, but I would be interested to know.

Answer:

People with type 1 diabetes who have good blood sugar control are more likely to avoid serious complications than those with poor control. The test called a hemoglobin A1c that provides an indication of the average daily blood sugar has been tied to complication predictions. Better control results in fewer complications and worse control results in more complications.

The additional wild card is that there are likely to be genetic modifiers of the probabilities because some people with severe complications may not have bad control where people with no complications may not have been as aggressive with their diabetes treatment and have less than optimal control. I think your husband should monitor often, shoot for his blood sugar goals, and do the best he can. If he can avoid kidney damage, that is the best marker for a healthy life.

JTL

[Editor’s comment: See discussions about the results of the DCCT study.

WWQ]