When you say that, do you mean if one neglects themself by disregarding their diabetes care to the point it will happen
Or is there just a random chance it will happen when ever it wants to, Like being diagnosed with T1 Out of nowhere?
First of all, rollercoaster blood sugars happen in many people who try very very hard and definitely don't neglect themselves. Please don't suggest to anyone with horrible diabetic complications it's their own fault for not looking after themselves.
I'm one of the lucky ones so far in that I can keep my numbers more stable than many, but I don't think that is because those others are neglecting themselves or not trying hard enough.
For some, diabetes simply behaves unpredictable and ridiculous, others may experience burn-out, depression, a busy family and work, some may live in the USA and can't make enough money to obtain enough insulin. I wouldn't call any of those circumstances neglecting yourself.
As for your question, I don't think there are sound statistics over multiple decades to prove or disprove high blood sugars are the only cause of complications. Those complications usually only show after a couple of decades.
To know how stable somebody's blood sugars have been over say, 40 years, you'd need CGM data over that time, which doesn't exist.
To provide trustworthy statistics you'd need those data over decades from a very large group of people, a substantial part of which has to be very well controlled, or you wouldn't be able to proof either way.
We can only work with what we know now. That is:
- High blood sugar definitely causes damage.
- Statistically, diabetics are more likely than non-diabetics to develop complications associated with diabetes that non diabetics.
- Low blood sugar is dangerous.
Personally, I prefer to believe keeping my bg in range most of the time will protect me from complications. I'm sure keeping healthy levels vastly improves your chances on not developing diabetic complications.
But I may live to a 100 without problems and still not prove anything, as I'm only one person.
As long as statistics say I'm at risk because I have diabetes, I'm happy to have my kidneys, feet and eyes checked occasionally, however low risk I think I am.