are complications inevitable?

[howie]

so i was diagnosed a few months ago and after a while got use to the idea that if i maintain good control then i will avoid complications, but the more i research and the more medical professionals i speak to i am continually finding statistics that say even with ideal control there's still significant risks of complications and at best i can only 'minimise my risk' or slow the progression.

i know there's people out there complication free after many years but they seem like a lucky minority (that probably maintain a small amount of beta cell function or something). i'm reading stuff like even with good control that around particular areas of the body e.g 'eyes and kidneys' good BG levels can't be maintained and there's nothing that we can do about it so eventually there'll be damage.

apologies for the bleak outlook, i'm just hoping someone can prove me wrong.

 

[cugila]

Howie.

If I didn't know better then I think I would feel depressed after reading your post. :?

Nothing in life is inevitable. If you take control of your Diabetes you will change your destiny. Listen to all the negative thinkers, be they medical professionals or just other Diabetics who have given up - you will fail.

There is no certainty you won't get a complication or two. It happens. Doing something to try and stop it happening - that's the challenge. Sometimes research can be daunting. You need to sort out the good information and the frankly rubbish opinions. As for statistics...you can find a million different ways to prove something or nothing.

Look around here at all the success stories. They haven't given up, they are fighting back and letting these so called 'experts' know we aren't giving in without a fight. :twisted:

Ken

 

[fergus]

Absolutely not.
Healthy people with normal blood sugars don't get complications. If we maintain normal blood sugars, there's no inevitability about us sufferring from them either.
I'd go further than that though. Many complications appear to be reversible provided blood glucose is normalised.

fergus

 

[howie]

yeah cugila you're right that is pretty depressing, apologies again lol, i'm sure you've all been through this stage.

and fergus i hope you're right bout normal BS maintenance, it's nice to hear someone being so positive about it all.

 

[janabelle]

Hi, there has been some controversy surrounding the lack of c-peptide in synthetic insulins. As C-peptide plays a part in preventing heart and kidney problems, it's quite probable that even well controlled type-1s on synthetic insulins could develop complications'
The long-term, and safety of insulin analogues is unknown. Many patients are now put, or forced, onto synthetic analogues and no-one can predict the long-term possible complications for these type-1s. Sorry it's depressing, but true :cry:
Jus

 

[howie]

it can't be too long before they bring out c-peptide and thiamine with insulin though can it? probably cost effective in the long-run.

 

[hanadr]

Howie
I'm not alone in thinking that the key is in the "good Control"
Non-diabetics average HbA1c is 5.1% and it has been shown that non-diabetics with Hb A1c above ideal( about 4.6%) are prone to diabetes type complications. So if you accept the medical establishment's Good Control as HbA1c of 7%, you are obviously at risk. However, if you get to the "ideal" level, you might well escape. Read Bernstein and Mendosa on the subject.
As to progression, I am a T2, so a little different, but At the moment I am trying to keep control on diet and exercise alone. 6 years ago I was taking 1500mg Metformin and 40mg Gliclazide per day. I have slight retinopathy( present at diagnosis), which is improving. Last Hba1c was 5.6% and I'm waiting on the results of blood taken yesterday. My meter shows an average of under 6mmol/l.

 

[kegstore]

Howard, I think it depends on how you interpret the statistics. Here is my version: a lot of diabetics get complications because a lot of them don't keep their blood sugars below 7 mmol/l, which appears to be the tipping point at which levels become toxic to the vascular system. "Good control" is an interesting phrase, because it depends entirely on how the range is defined. The expectation is that most diabetics will not get their numbers into a genuinely "safe" range, so if you can (and some - albeit a minority - do), then you REALLY are minimising the risk and going beyond what the statement alludes to. Which is kind of positive...?

 

[kewgirl]

Hi Howie

I am approaching my 40th year as a Type 1 diabetic and so far I am fully functioning and on a good day everything still works! :lol:

Whilst echoing previous replies to your posting that getting good control of blood glucose levels is paramount I would also add

One of the other single most powerful things a diabetic can do is NOT TO SMOKE.

When I commenced my professional career I worked on a male hospital ward – in those days i.e. early 1980’s patients were allowed to smoke on the hospital wards! :shock: Seems absolutely staggering to think that happened but it did.
We also had no “piped oxygen” unlike the modern facilities we have today. Instead whoever needed oxygen would have an oxygen cylinder placed at their bedside with a large notice stating "DO NOT SMOKE OXYGEN IN USE" while the patient in the next bed was lighting up and puffing away! :shock:
This ward housed mostly smoking diabetic patients with missing limbs. After I completed my time their the nursing tutor who knew I was diabetic informed me they had put me there as a test! Not sure that would be “allowed” these days. :!:

The complications associated with diabetes that are thrust out all the time also do not take into account very positive advances such as home blood glucose testing, HBA1C’s, and screening.
Screening does save lives and if you ensure you have regular check ups then at least potential complications can be picked up early.

The reality is that many many people with diabetes & many other medical disorders just do not attend for their hospital/GP appointments. :evil:
There are many reasons for DNA’s (Did not attend) hospital appointments, which for the purpose of this reply I am not going to go into but as someone who wants to optimise his health I am pretty sure you will attend all your appointments.

I was very fortunate to undergo prophylactic laser eye treatment way back in 1992 as part of a clinical trial – with the aid of my trusty spectacles I have no major eye complications – just a tiny hint of a peripheral cataract – but I may have got that anyhow.

Next year I will celebrate 40 years on insulin and I am damned determined that I will
Get to 50 years and get my Insulin Medal.

Wishing you all the best.

Txx

 

[yipster29]

great post Kewgirl!

 

[Spiral]

I'm T2 not T1, and relatively new at this. However, what has amazed me is what low standards the medical profession has for good control :? There has been quite alot of news about htis over the last few weeks. Maybe the standards will be revised. I hope so.

At diagnosis I felt very depressed at the inevitability of eventually taking medication and then insulin and my feet still dropping off. I looked around until I found a theory I could work with largely thanks to this website and the many very well controlled diabetics on it, some of whom have reduced the amount of medication they take, reversal of some complications and some (T2 obviously) who have come off medication altogether.

I feel a lot more positive now :mrgreen: and my goals of normal blood sugars seem achievable.

 

[copepod]

Howie, I'm guessing you were diagnosed at an age older than teenage? For those diagnosed as children, teenage years are often when they have a few years of poor control, and many more years of life beyond that. If you develop type 1 diabetes as an adult, you are unlikely to go through such a period, and more likely to maintain good control for your whole life, resulting in very low chance of complications. Also many complications need years to develop, so if you get diabetes, at say age 30 years, you have around 50 years to 80 years, rather than 75 years from age 5 to 80.
I developed the condition aged 30 year, 14 years ago, and have no signs of any complication - and hope to continue this situation for many years yet. I wasn't taught any carbohydrate counting, but worked it out for myself, and, equally important, continued to be physically active, with cycling, orienteering, adventure racing, canoeing, swimming etc.

 

[LittleSue]

Diagnosed in 1973, I had v.poor control most of the time (despite my best efforts, not wilful neglect) until around 4-5 years ago. Carb counting hadn't yet gone out of fashion, but the target was to have a little sugar in the urine all the time (bs around 10-12). Despite that, my only complication has been a minor eye problem, after being told strictly not to adjust my lantus until I'd had CGMS - which dragged on for 15 months! OK maybe it was just the past catching up with me, but rather a coincidence that it happened when I knew my overnight control was poor. Prior to that, every year the optician had said he wouldn't have known I was diabetic from examining my eyes.

Complications don't seem to be inevitable even if you fall off the wagon a bit (or in my case, take 30 years to get onto the wagon). Obviously I'm not advocating poor control! Maybe I'm just lucky. Doesn't stop me striving for better control though, it's nice proving the doom-mongers wrong!

 

[janabelle]

God do I feel like one of those afore mentioned doom-mongerers now!
I'm not honestly- I rarely believe statistics,I''ve my son and a very close friend who both survived cancer despite been given the worst prognises.
Keep up the gr8 postings Kewgirl-you're a porker like me!
Jus x

 

[chocoholic]

When I spoke to a doctor recently, he said he knew diabetics with poor control who had no complications but also diabetics with good control who got complications, so he thinks it's the luck of the draw. I tend to think striving for good control must be preferable, so intend doing what I can to achieve that.

 

[graham64]

The following two studies show intensive BG control can reduce the risk of Diabetic complications in both T1 and T2.

T1

http://diabetes.niddk.nih.gov/dm/pubs/control/

T2

http://www.diabetesmonitor.com/d03.htm

Graham

 

[bmtest]

Howie

Not in my book I refuse to accept them till it happens, achieve a good balance of control and life enjoyment and you wont be far out.

Life is that short it is hardly likely you will succumb to anything serious just keep everything well oiled and used also do not think to much like a diabetic.

They use to tell me not to ride a motorcycle at the clinic and not to run barefoot around the city centre with the Karate club as a teenager but it never stopped me.

I would say I am as fit as non diabetics this weekend I dropped all my daytime insulin while I plastered my sons bedroom walls and ceiling my blood sugar still were under 4, this is my weapon against complications extreme DIY and a fitness programme that I have kept going since diagnosed.

To quote the consultant who headed up the Diabetic Clinic he said "in all these year I have been in here I have never once seen you, you will probably one of those who will escape any complications".

I hope it turn out to be true, it is down to test and test again if in doubt and watch out for the peaks after slap up meals.

For example if I commence a 4 hour car journey I will test before I set off and when I arrive at the destination any speed wobbling at speeds of 70plus or judgment errors like seeing an extra lane I dip in to the jelly babies to be safe, my wife and kids are usually blind folded for the length of the journey.

The other factor is the older you get the less you worry I was told this year ago by my boss who used to down at least 7 pints at dinnertime and then struggle to use the photo copier thankfully them days have gone so forget it more non diabetics you know will drop by the wayside before you for what ever reason it's life.