Hi Amanda
Long term diabetes, well to give you a bit of perspective on this little gem, I've been diabetic for 21 years now, and my husband been diabetic just under 31 years, and we both still lead a very active life and nither of us any major problems with any complications, though my husband did have problems with eyes 10 years ago.. But it does need to be remembered that when we joined the diabetic club, available treatments and kits were a lot more basic than available to day.. 31 years ago, no was no method of testing blood glucose at home, you could with a mini lab kit, test urine to see roughly how much sugar it contained :roll:
Even when I joined the club blood glucose testing, was done with a colour guide, meters came in several years later, very basic and cost the earth (my first meter set me back £150 VAT free) and took 2 minutes to produce a blood result!
So as you can see, we've faired very well and for diabetics that join the club today, prospects are a lot better than when we joined..
The trick is to maintain good control as much of the time as possible, there will be times when it's difficult to do so, illness, stress etc even a odd celebrations can knock out the levels a bit, but if over-all if your you maintain an high percentage of the time with good control then there should be no worries...
As to your querry of the 4.5mmol/l and taking sugar, this in some ways, a difficult on as for me it would depend on what I intended to do next to what I would do.. If I wasn't far off from having a meal then I would leave it..
But if a meal was some way off, exercising or driving I would have something to eat, this could be anything from 2/3 jelly babies if driving, to having biscuits, piece of fruit.. In the main what you to watch is that you don't cause your sugars to spike, so a slow acting carb might be better than adding sugar to a drink.. But some is down to personal choice though..