Complications of diabetes (mainly type 1)

I agree 100% that good glucose control is VERY important for good diabetes control but that is only part of the equation to avoid complications. Beta cells make PROinsulin. Proinsulin is part inslin (to move glucose out of the blood and into cells for energy). The other part of proinsulin is c-peptide. C-peptide is the part of proinsulin that protects and repairs any damage that glucose metabolism causes. This is why people who DO NOT have diabetes DO NOT have diabetes complications.

If you care to read up more on C-peptide, please check out these links:
http://care.diabetesjournals.org/content/27/6/1506.full.pdf
http://www.medwire-news.md/57/80931/Diabetes/C-peptide_protects_against_microvascular_complications_in_Type_1_diabetes.html

Many people have trouble achieving A1Cs in the 5’s without frequent and sometimes severe hypo episodes - I would not be so quick to tell people that’s where they should be aiming unless I were their physician.

If you’re going for that level, you need to be on a very intensive management program with your Endocrinologist, IMHO.

Thanks for posting Barb. Posts like yours gives me a lot of hope. I was dx’ed late in life type 1 (52) so if I can do 30 years, OK, I’ll be 80+ LOL

I really don’t know how to stay complications free.
I work in hospital and i see a lot of patients with complications. Some of them have A1C 6,5 and some 11,7. All of them have complications. I would like to see my future. Then i would live more and maybe stress less. I don’t have a boyfriend or someone to support me. I have hard work and from last week i exercise a lot - 5 times per week. And still, it is not good enough for me. Altough i smoke, i know it’s bad. And i am smoking my last pack of cigs. Anyway…
Depression is getting in to me and i don’t know what to do… :S
I hate to be alone
I sometimes hate my work, it makes me sad
I hate that I can’t get my wight off - i used to weight 89 kg and now 76 and I can’t get it down.
I hate that i can’t drink as much as i want
I hate I have to mesure my bg 4 to 8 times a day - i don’t know if it’s even saving me from getting complications.
And most of all I hate that i can’t bredict the future!!!

I like your comment. I have been a “brittle” diabetic for 39 years. There’s no way I will ever get the near normal blood sugars most diabetes educators and professionals want (I drop very quickly and without warning. I am lucky that I generally recognize low blood sugar and do not pass out). Many times I feel very battered by the demands that all diabetics achieve the same numbers. We are individuals.
I really like your pointing out the average problem with A1c’s. I explained that many times–A1c only measures highs.
It’s reassuring to know others are dealing with the same things I am. Most of the diabetics I have know had complications and several have passed away (both who were in high school with me died of hypoglycemia–there were no glucose meters back then so it was all guessing). I’m in good shape–no complications, no real limits on lifestyle, etc. What I am doing works so I just keep going with it, even if I am not a text book diabetic.

I would note that an A1c is actually average elevated blood sugar. The readings at or below 80 (I think) have no effect on A1c, if I understand the test correctly.

Well this isn’t very encouraging since my a1cs are usually in the 7s.

Perfect response Gerri!

Yeah, I agree. But it is a nice goal for sure! Years ago a # that low was unheard of. I’ve always been in the 6’s and I experience quite a few lows. But…I am believing more & more that perhaps being in that 5’s is do-able for some people.

A1C is a very good predictor of complications for groups, not for individuals. In other words: Some individuals with high A1C don’t encounter complications. Others with relatively low A1C do. Since you don’t know how your body will react to an elevated A1C it is like playing Russian Roulette. Play with one bullet or stick in a couple more. It’s all about how lucky you feel.

Diabetics tend to forget that even healthy people can in no way predict their future health. Diabetics often pay more attention to their health than others, so I am sure that helps. It’s also why one should not get stuck on that A1c number. You do what you can and deal with what happens. Life is never predictable. As one of my doctors told me: Everyone choses the risks they are willing to accept with their health, whether it’s smoking, or weight gain, etc. But we all have things we just can’t reach as a goal. Don’t dwell on these things too much–you can never be perfect.

Until recently I was convinced that there was no need for me to save a lot for retirement because of my drastically reduced life expectancy. Now that my BG levels are close to normal I have to step up my savings. Nobody talks about this diabetes complication.

Hi Laura,

I started another post
https://forum.tudiabetes.org/topics/what-is-diabetes-a-response-to.

because of your question here, and this is what I wrote.
Good luck.


What is Diabetes? A Response to a POST BY LAURA

When my mother got T2 Diabetes 25 years ago, she asked me
What is Diabetes?

I’m sure 95 % of you can write a 25 page summary quite easily.

But let me ask you again,
What is Diabetes?

I had just finished my university pathology studies when she was diagnosed.
What I saw in my studies, was that many diseases and conditions just develop in time/over time, as people age: heart, kidney, eye, blood vessel and circulation problems etc

And in the case of diabetes (both Type 1 and Type 2; i.e. both have high blood sugar in common!),
many of these things which would have developed anyway in time, just come sooner
(or possibly not at all if one is lucky, based on genetic, environmental or lifestyle influences),
.

So, when my mother got T2 Diabetes 25 years ago and asked me
What is Diabetes?
I basically answered :
“Well all the diseases you could get as you age and get older, they just come sooner !”

25 Years later, I still stand by that answer: of course, if one’s blood glucose is out of whack for a long time, many other things can easily be brought on too!

What I tried to do was lessen her ‘fear’ of of what diabetes really is.
Again I believe with Diabetes,
“Well all the diseases you could get as you age and get older, just come sooner !”

After 25 years, my mother is more or less complication free now.
The the first 10 years she was on oral meds, and the following 15 years on shots.

She understood that she needed to keep her blood sugars down, otherwise:
“Well all the diseases you could get as you age and get older, just come sooner !”

So many people may have a fear of diabetes, and what an extended ‘list’ of ‘mysterious’ complications it may bring.

So, as I said above, many of these complcations are just those that would have developed in time anyway (or possibly not at all if one is lucky, based on genetic, environmental or lifestyle influences or decisions); and ofcourse, that if one’s blood glucose is out of whack for a long time, many other things can easily be brought on too!

So, my conclusion, diabetes should not be feared, but CONTROLLED,
It needs to be controlled, otherwise
“… all the diseases you could get as you age and get older, will just come come sooner !”

Of course, the experience in the modern age is that if Diabetes is fairly well controlled, the complications can certainly be delayed by many many years or even avoided all together.

This threads was posted after I read the post below by Laura.

Diabetes patients should not suffer anxiety that comes with such concerns as hers,
but they should put their energty to better CONTROLLING their diabetes.

I wrote this post up to 'PUNCH THE DIABETES MONSTER ON THE NOSE !! ".
Thats what Diabetes patients should be doing by better CONTROLLING their diabetes -
PUNCH THE DIABETES MONSTER ON THE NOSE !.

So again,
“What is Diabetes?”
Understand this, and one should really be on their way to a better life with D.

Jim, I agree with you 100%. Not all Type 1’s can achieve this (5%) nor should they. A Diabetic can have higher A1C’s and still do well and some that have lower A1C’s can have more complications than those with higher A1C’s. I am not stating that the risks are not higher with an elevated A1C just that everyone is different. What may work for Pauly or anyone else may not be right for you. This is really something to determine with your physicians advice.

good comments all around. three additional thoughts:
(1) you are young enough where you can still benefit from the “legacy effect” of early control. there are studies indicating that those who maintain good control for the first decade after diagnosis do much, much better than those who do not over the long term. the less damage you do to yourself now, the better.
(2) not all complications are created equal, and many complications are treatable or at least manageable. tight control is the single most important way of making the complications you do get less serious.
(3) i’d be sanguine about your future prospects given how quickly the technology is evolving. i’m not going to get into the “will there be a cure” debate, but closed-loop technology is in the pipeline and i imagine it will be around for the vast majority of your adult life. even the pump and current MDI protocols are way, way better than the insulins available to people a decade or two ago.

So true!!!

Right on Amy! Sooooo true!!! I was/am good controlled T1 D but had serious complications yrs ago.
The Dr.s are sadly clueless, about some things (and things change drastically over time). All you can do is try your best to control your disease and live a happy, healthy life.
But Amy is so right…what may work for one person may not for another.

I was dx’ed in 1984 and, while I haven’t had ‘official’ complications (besides occasional trips to the ER for severe hypos, mostly when I was in my 20s but one snuck up on me last year, total user error situation…oh well…), I have noticed some delays with wound healing and scarring from what I would consider minor leg injuries, like barking my shin on a coffee table? I think that the hair on my lower legs is getting thinner too which is not something I think I would have if I didn’t have diabetes? I also have one toe that gets colder than the other ones that a podiatrist rx’ed some neurotnin cream for. I’m not sure if it helped or not as I subsequently moved and no longer hang around the dojang w/o shoes on in the winter.

I had a wierd incident in December 2009, the first time I ran > 30 miles in a week. It was cold and I was doing 2x socks and was wearing 11 1/2 shoes when 12 would have been better, although I didn’t know that at the time. One of my toenails turned black, like it was bruised and got red and puffy so I went to the doctor and, while it was no big deal, they were like “it’s REALLY important that you come in and get this stuff checked out” so I had an rx for some strong antibiotics and it went away. Still, I could have just as easily blown it off and who knows what would have happened? My A1Cs were 5-6 for much of my ‘career’ aside from 2007, when I had an excursion to the 7s for a year and have been in the 5s since that time. Still, it is definitely a concern. I have no idea what the inside of my heart looks like and, at 43, the thought has crossed my mind that that could blow up at any moment?

The loss of hair on the lower legs is actually a subtle complication that most medical professionals are unaware of. Dr. Bernstein notes this as one of the few complications that he had which were irreversible. It is probably an early microvascular complication. I lost the hair on my lower legs years ago, always attributing it to wearing boots, but in truth the pattern of hair loss has nothing to do with where my boots rubbed. I have come to believe that I can minimize my complications by keeping my blood sugar tightly controlled, but I am still at risk from complications. I think that there is stuff going on as a diabetic that can cause complications independent of how well you control your blood sugar. It is something about imbalances of things, perhaps some other hormones.



So I’ll continue to control my blood sugars and do my best to minimize my risk of complications. But I also have to just be realistic, everybody is at risk of certain things like heart problems and just being diabetic means that I’ll have some added risk no matter what I do.

I’m sure the compression sleeves I wear on my calves for running don’t particularly help but still…