Does tight control guarantee No complications

I am wondering if anyone knows if having great control would avoid any diabetic complication.

Unfortunately, death and taxes are the only guarantees one has in life! Keeping BG’s in a good range reduces, but does not eliminate, the risk of complications. That’s definitely a good thing to reach for, but it offers no guarantees.

Many of the complication risks are clearly correlated to average bg.

The microvascular risks, especially retinopathy, neuropathy, and kidney disease, are known to be strongly related to average bg and blood pressure that can be controlled.

Note that even the lowest A1C bins show nonzero risk.

And people who don’t even have diabetes can develop the conditions that for diabetics are attributed to diabetes complications

So we try our best but don’t beat ourselves up.

A good attitude like yours is a potent resource to deal with diabetes … and life!

As stated above, tight control doesn't guarantee no complications. There are no guarantees, ever.

But it improves the odds fantastically. The prospects are enormously, stupendously better. And since this is the only game in town, so to speak, it pays to play the odds.

If anything I’m sure it slows the progression of complication.

Note that the DCCT research doesn't include any A1C's below 6.0!

In some cases, it can heal/reverse compications. Two that have improved greatly for me with tight tight control are peripheral neuropathy, and early signs of kidney damage.

Had significant issues with neuropathy in my hands and feet after I was wildly out of control for about 2 years. Got tight control in place and stayed there, got my a1c down from 11+ to 6.8 in 3 months, kept driving it down, to where now, a year plus change later, I'm at 6.0 and feeling good I'll get to my goal of 5.5.

The neuropathy cleared up completely in about 9 months. Protein leakage in my urine has abated as well.

The spectrum of "diabetic complication" can have other causes than D, so non-D's get those things too. This is why the risk can not be driven to zero, but in theory could be driven to a risk profile close to a non-diabetic.

Thank u its good to hear that healing and reversals are possible. Do u know if good control can also help with retinopathy and DME?

I don't think tight control guarantees no complications. I have had pretty tight control for a while now and haven't really ever seen an A1C > 8 (ok, once in college, which is when I started my MDI "homebrew" adventures...) and have been 6s since the early or maybe the mid-90s when I started seeing the doc regularly and not > 5.8 since 2008, when I got a pump, only one 5.6 since I got a CGM in 2010 and everything else has been below that, like 5 or 6 5.1s in a row, marred only by a holiday/ getting used to Enlites 5.4 last winter.

I still have been losing hair off of my legs and feet for several years now, which is a complication of sorts. I have 2x or maybe it was 3x bleeders in my retina. The doc said "if you had like 100, we'd fix it, but we'll keep an eye on it...". I also have noticed very slow healing wounds, like scrapes and scratches. I didn't have trouble with a couple of minor surgeries but things like where I wonked my knuckle on some guys belt at the 2011 Chicago Marathon, in October, that then didn't heal completely until like June. Maybe the knuckle location was sort of aggravated but, at the same time, maybe it had to do with diabetes somehow? It's hard to say since they aren't exactly life-threatening but I've seen how those things can go south and the consequences can be grim!

You’re also in your mid 40s so the hair on your legs could just be migrating up to your back, sides, and shoulders

Thanks for the "mid"! At 47, that's a huge compliment!!

Although tight control doesn't guarantee no complications lower bg does help a lot imo and in the findings of many studies. But I think too many fluctuations and other things like high bp, being overweight and numerous other issues which may combine together can contribute to it. The truth is no one really knows but if your bg is chronically high you will get them for sure eventually. I think it's also important to qualify tight control, trying to stay too low all the time can be stressful and dangerous if you're having bad hypos, so everyone has to figure out what works best for them.

Acid if I replied to this before sorry. I’m on my phone and it does have a mind of its own. Ur BG readings have been excellent. And still the bleeds. The reason I ask is I had a vitrectomy 10 days ago.It went well. My BG was never tight controlled. I think it is really a toss of the dice. After 30 years of this disease I feel lucky. And I still will not feel bad for that piece of cake I had 0nce and a while.

It does in my case.

When I was diagnosed with diabetes a couple years ago I had also developed related eye problems. I was treated with intraocular injections for DME. The swelling disappeared, but half a year later the doctor noticed upcoming signs of a new swelling in one eye as well as a growth of new blood vessels in the same eye.

My diabetes was under control from the very beginning (A1C around 5.8) except for the month preceding the eye exam. I reestablished the control and the signs of the swelling disappeared by themselves. New blood vessels had to be treated with laser, though.

Dr.Berstein suggests in his book that diabetic retinopathy is reversible and I saw somebody mentioned this kind of experience here in the discussion about his approach.

About a month ago I managed to spend a week with average of around 90 (being under influence of people's stories from that discussion :)) and I was surprised to notice improvements in my feet feelings and general well being after only one week of such tight control.

I think you mean Dr. Bernstein? And yes his recommendations are a bit 'excessive', but I do not want any complications so I have bought into his advice and am now a member of the 4% club. But I am type II and do not have to worry about hypos.

Nope, tighter control brings risks as well. No guarantees Vikki. Less likely get complications perhaps, but no absolute guarantees I'm afraid.

Thanks Stuart for the reply. Starting lantus to night. Little scary worried about lows while sleeping. I’m also on glucotrol ER 10 2xd. The pills were not doing it. BS come down to 9 when I added metformin. But could not leave the house the runs u know. Was 12 a1c. Now 9 so I need the lantus. Will not take any new on the market pills. I opted for shots. Vikki