Do you still get complications if you keep your blood sugar in the normal range?

[islandkris]

I got my blood tested every year since I was 20. I am 31 now and was diagnosed almost a year ago. My a1cs are always good ( in the 5's ) and I haven't had the disease for more the 2 years. If I keep my sugars in check, will I still get the complications like neuropathy?

[princesslinda]

Since diabetes is progressive, IMO, it makes sense that eventually we'll all progress over time and develop some complications as we age. Even non-diabetics develop complications as they age.

I would certainly think keeping #s in check would slow the progression from what it would be if #s were out of control.

I figure if I do all I can and still have complications, i'll at least have the satisfaction of knowing i've done my best over the years.

[foxl]

Yes ... the idea is to push those complications back so far, you are gone first!

[Newdes2.0]

I got my blood tested every year since I was 20. I am 31 now and was diagnosed almost a year ago. My a1cs are always good ( in the 5's ) and I haven't had the disease for more the 2 years. If I keep my sugars in check, will I still get the complications like neuropathy?You're doin' great! You should be fine to ripe old age if you keep your regimen up. But I can tell you that 'under 50g of carbs' per meal is still nearly 'lo carb'. And that's one of the things that's helping you immensely. The normal dietary intake of carbs for a non-diabetics not trying to lo carb is between 250g-300g of carbs. So if you're under <50 per meal.. Well you see the point.

Keep up the great work!
Grant

[Lloyd]

I don't agree with the previous answers at all.

T2 is progressive. What that means is your pancreas produces less and less insulin usually, as time goes on.

That does not mean you are progressing to complications, just that it requires more work and more help from oral medications, and often from injecting or infusing insulin.

I had A1c's almost all in the 7's for 12 years on pills.

Now, on an insulin pump, my last TEN A1c's have been between 4.9 and 5.5.

I have had no complications, nor do I expect any. Complications come from high glucose, I don't have any of that.

-Lloyd

[Paul T2]

Been Type 2 for 6 years no progression yet eat ~50 gm carb per meal. Current A1c 5.2

[islandkris]

I am not worried about insulin. I am sure in the coming years I will eventually have to take it which is fine and i'll go straight to that before I take oral meds. My main concern is the neuropathy and heart disease that come with diabetes.

[Caravaggio]

I don't think anyone can say whether or not one will develop complications, even if one is in control of diabetes. Worrying about it will not help, but may even contribute to the development of these complications. What is more productive is for us to do our best to control diabetes in a manner most suitable to us and our chosen lifestyle.

[BlueSky]

I am not worried about insulin. I am sure in the coming years I will eventually have to take it which is fine and i'll go straight to that before I take oral meds. My main concern is the neuropathy and heart disease that come with diabetes.
You won't find a definitive answer to this one. But it looks like high blood glucose causes neuropathy and retinopathy. So if you keep your BG in the normal range, you shouldn't get these problems. But heart disease is different. People with metabolic syndrome (insulin resistance but normal blood glucose) have an increased risk of heart disease. And 40% of non-diabetics die from heart attacks. Maintaining normal BG doesn't change that.

[Lloyd]

And 40% of non-diabetics die from heart attacks. Maintaining normal BG doesn't change that.

Macro vascular problems (heart attack and stroke) are not really a complication of diabetes, for that reason. Being overweight, high blood pressure, condition of your arteries, genetics and other things all contribute to this. High glucose can increase your risk, but you really need to work on all these things as best you can, to reduce your chances of macro vascular problems or at least delay them.

-Lloyd

[dbaratta]

My doc told me the latest studies say if you keep your BG in check it is good but won't stop complications from diabetes. He asked me if I read the article and I had not. I do a lot of research on this stuff and previous studies stated that good control can stop complications, recent studies state it doesn't matter, but, this can change on a dime. Just keep things under control and hope for the best I guess. People live a very long time with diabetes so I belive what I read only to a certain extent.

[NewdestinyX]

My doc told me the latest studies say if you keep your BG in check it is good but won't stop complications from diabetes. He asked me if I read the article and I had not. I do a lot of research on this stuff and previous studies stated that good control can stop complications, recent studies state it doesn't matter, but, this can change on a dime. Just keep things under control and hope for the best I guess. People live a very long time with diabetes so I belive what I read only to a certain extent.Yeah -- the info out there is mixed... But as with anything like this it's always good to err on the side of 'caution' -- so all of our goals should be to have a 'normal' BG range and that should stave off complications for the longest time. The rub is that in midlife we usually have good enough musculature and heart function to exercise well and keep our metabolisms up and keep the weight off (knowing that Insulin Resistance, T2's main issue, is predominantly there as a result of obesity).. As we age that will become harder so the complications will likely kick in eventually.

But as my mother says.. Something's gonna kill us all eventually - it's just a matter of time. But like others here I just want that to be as far off as possible.. Though blindness would be indeed horrible -- even more horrible to me is the notion of daily 8 on a scale of 10 level pain day in and day out due to neuropathy. Don't know if I could do life like that.

So we plug away -- don't we.. Chasing that forever in front of us 'perfect BG level'. Keep up the good fight my brethren and sisteren... :)

[dbaratta]

Yeah -- the info out there is mixed... But as with anything like this it's always good to err on the side of 'caution' -- so all of our goals should be to have a 'normal' BG range and that should stave off complications for the longest time. The rub is that in midlife we usually have good enough musculature and heart function to exercise well and keep our metabolisms up and keep the weight off (knowing that Insulin Resistance, T2's main issue, is predominantly there as a result of obesity).. As we age that will become harder so the complications will likely kick in eventually.

But as my mother says.. Something's gonna kill us all eventually - it's just a matter of time. But like others here I just want that to be as far off as possible.. Though blindness would be indeed horrible -- even more horrible to me is the notion of daily 8 on a scale of 10 level pain day in and day out due to neuropathy. Don't know if I could do life like that.

So we plug away -- don't we.. Chasing that forever in front of us 'perfect BG level'. Keep up the good fight my brethren and sisteren... :)

I totally agree. That was only one study that suggested it didn't matter. I know first hand of people I work with who don't take care of themselves and have lost limbs, have heart and kidney issues, and have even lost lives. 2 people in my family lost their lives to diabetes, it is NOT going to be me!!!:eek:

[Lloyd]

The DCCT, UKPDS and other long term studies of thousands of T1 and T2 diabetics, for 10 years or more, (and follow up studies too) all say the same thing.

A lower A1c brings with it a lower chance of microvascular complications.

You can plot the A1C vs % of complications on a graph

Going so low you get hypoglycemia is not a good idea though.

-Lloyd

[NewdestinyX]

I totally agree. That was only one study that suggested it didn't matter. I know first hand of people I work with who don't take care of themselves and have lost limbs, have heart and kidney issues, and have even lost lives. 2 people in my family lost their lives to diabetes, it is NOT going to be me!!!:eek:There ya go!. I'm with ya.. But let me ask -- in the case of the people you mention who've lost limbs and life -- they were people that 'didn't get control' of their T2 - right? Not people who were on top of it and good numbers where the T2 has simply 'progressed'?? regardless of their attempted and success at controlling?

I've always felt that despite taking away our food choice - T2D is one of the most merciful diseases to get since it can be 'controlled' by our actions.. unlike most cancers or MS or others..

[imac]

I have been type 2 for 16 years, all that time on oral meds, some so old they dont even list them now. my. bg was always within limits. Now at 72 years old i have heart failure (probably heredity) failed kidneys, caused by severe heart attacks, I am now on insulan and wish that i had been all those years. diabetes is progressive and if you live long enough you will get problems.

[MrsMia]

I have to say that this thread thoroughly depressed me. It appears that no matter how well you manage your diabetes it doesn't mean a thing. At least that is the message I am getting. It seems like when I finally find myself feeling "up" there is some way I get drug back down.:(

[princesslinda]

Life is fatal, whether you have diabetes or not.

Don't let the "what if's" rule your life. Worry is counterproductive, we do the best we can and live our lives.

We know that high blood sugars affect our bodies negatively, so keeping them as normal as possible will give us the best outcome.

When I feel "bummed out" by my diabetes, i'm reminded of my brother-in-law, who at age 40 had sudden onset of pain, and was found to have Stage IV lymphoma. He died at age 41, having been quite healthy until that point.....my diabetes doesn't seem bad at all in comparison.

[NewdestinyX]

I have been type 2 for 16 years, all that time on oral meds, some so old they dont even list them now. my. bg was always within limits. Now at 72 years old i have heart failure (probably heredity) failed kidneys, caused by severe heart attacks, I am now on insulan and wish that i had been all those years. diabetes is progressive and if you live long enough you will get problems.With respect - if your BG level was kept normal than it can't really have been the cause of your other issues. Diabetes' 'trigger' of complications IS the high blood glucose level. So 'normal' blood glucose - no complications. I think your idea of 'heredity' is more at issue with the heart complications - don't you think?I got my blood tested every year since I was 20. I am 31 now and was diagnosed almost a year ago. My a1cs are always good ( in the 5's ) and I haven't had the disease for more the 2 years. If I keep my sugars in check, will I still get the complications like neuropathy?I came back to this thread and found myself a little confused -- if your A1c's were always in the 5's why did your doctor diagnose you as a T2 diabetic. And if carbs don't affect your BG number -- I'm confused as to why you are a diabetic. And to answer your question -- if your blood sugar numbers are 'normal' and they stay that way -- you shouldn't experience complications - according to what I read. And it also stand to reason that 'hi sugar' is the 'reason' for the complications.. So if it's 'not high' - then no complications.

[Moonglo]

Grant,

I'm willing to bet that the op meant that the a1c has been good since diagnosis... but even if not, the a1c is not a diagnostic tool usually. The GTT and fasting bg's are a much better indicator of diabetes. Think of it this way... if you fail one test, with, let's say a 50, and then make a 90 on the next one, your grade in a class would be about a 70. That doesn't mean you didn't have problems on that first test... it just means that you did well enough on the next one to gain back some points. A1c's are kinda the same way... if you have enough hypos and enough hypers, they will counteract each other and masquerade as normal bg, when in fact the problem is still there.

I tend to agree with Princess Linda. Something is going to kill us, whether it is a complications from D, a car accident, a plane crash, some other illness, or whatever else. Diabetes is not a death sentence, just a wakeup call.

I have to keep looking forward; pondering over whether or not I have doomed myself to die a horrible death from diabetes complications does nothing for my motivation.

[islandkris]

With respect - if your BG level was kept normal than it can't really have been the cause of your other issues. Diabetes' 'trigger' of complications IS the high blood glucose level. So 'normal' blood glucose - no complications. I think your idea of 'heredity' is more at issue with the heart complications - don't you think?I came back to this thread and found myself a little confused -- if your A1c's were always in the 5's why did your doctor diagnose you as a T2 diabetic. And if carbs don't affect your BG number -- I'm confused as to why you are a diabetic. And to answer your question -- if your blood sugar numbers are 'normal' and they stay that way -- you shouldn't experience complications - according to what I read. And it also stand to reason that 'hi sugar' is the 'reason' for the complications.. So if it's 'not high' - then no complications.

I have gone into the doctor every year since I was 24 for a physical and blood work. 2 years ago he told me that I needed to watch my sugar intake because my triglicerydes were higher. Last december he did a fasting glucose on me and I was 7.7 which automatically makes me type 2 diabetic. He gave me a GTT right after my fasting glucose and I averaged 8.2. For some reason he did not order an A1c on me until I asked him to 3 months later because I didn't know what it was until one of my family members who is diabetic told me about it. I guess it also didn't help matters that he went on vacation for 2 months as well. By the time I got one I had already lost 40 pounds and was eating properly so I guess i'll never know what my original one was. I recently had my gall bladder out and for a day and a half I couldn't get my blood sugar below 12 no matter what I ate. Carbs do effect my glucose numbers if I am not careful. It is only with lots of exercise that I can manage this.

[islandkris]

Grant,

I'm willing to bet that the op meant that the a1c has been good since diagnosis... but even if not, the a1c is not a diagnostic tool usually. The GTT and fasting bg's are a much better indicator of diabetes. Think of it this way... if you fail one test, with, let's say a 50, and then make a 90 on the next one, your grade in a class would be about a 70. That doesn't mean you didn't have problems on that first test... it just means that you did well enough on the next one to gain back some points. A1c's are kinda the same way... if you have enough hypos and enough hypers, they will counteract each other and masquerade as normal bg, when in fact the problem is still there.

I tend to agree with Princess Linda. Something is going to kill us, whether it is a complications from D, a car accident, a plane crash, some other illness, or whatever else. Diabetes is not a death sentence, just a wakeup call.

I have to keep looking forward; pondering over whether or not I have doomed myself to die a horrible death from diabetes complications does nothing for my motivation.

Most of my family members do not take care of their diabetes. My father in law is happy if he gets up and his blood sugar is 7-8. He says 10 is no big deal after a meal to which I completely disagree. I feel bad for him and wish that he would look at it a bit different but he says that once you have had the disease for 20 years you don't care anymore which i also disagree with. I can see he is getting neuropathy and bad circualtion in his legs cause they are always bruised and have lost all the hair. My grandfather is on insulin and he has had it for 20 years as well. He has had 4 heart attacks, a stroke and lots of cholesteral and blood pressure problems. He eats chocolate and lots of carbs all the time. His feet look aweful and can't feel much in them anymore. How he made it to 83 i'll never know. My uncle is an alcoholic and doesn't take care of his either. When I checked him while I was in saskatchewan he was 16 before he ate. He has had the disease for 20 years as well but there are no visible signs that he has complications but I would guess that they must be there and I would think his kidneys are ready to pack it in. My aunt is the only one who watches what she eats and is very on the ball with her diabetes. So I seen enough of the complications to make me think twice about eating bad foods and exercise constantly. I set a healthy lifestyle because I want to be around for a very long time. I ahve 2 daughters that are 4 and 18 months and I want to watch them grow up and have children of their own. I also want to set the bar because they are highly at risk for getting the disease when they are older and I want to at least prolong the onset incase they do get it. I am a stay at home dad and I cook everything from scratch. I can my own foods and raise my own beef. I always have done those thing but as a teenager I would go to the store constantly for chips, candy, pop and have very large meal portions. I am a big guy and my normal weight is around 230 and that would make me very skinny. I was 370 pounds when I was diagnosed and I am 279 now. I am glad I was able to catch this very fast and I hope that I can live a long and happy life free of diabetic complications. For all those reasons I will tow the line and eat properly and exercise lots.

[foxl]

Well, not to be your little ray of sunshine this morning, :mad:

but I am reading a book, Heart Disease and Diabetes, Miles Fisher, Ed., 2003; it discusses Diabetes and Insulin Resistance as THE underlying cause of CVD. Rather horrifying overall and motivating me to exercise more.

I am not finding the section I wanted to quote here, but apparently atherosclerotic damage is evident decades before
T2D gets diagnosed. So, your blood sugar would measure in the normal range, yet elevated insulin levels would already be messing up your blood vessels. Great, huh?

This book is quite dismaying overall.

Not to end on a downer, CVD can be slowed or headed off by all the usual advice -- exercise, controlling BP and lipids. Even after diagnosis. SIGH.

[NewdestinyX]

Grant,

I'm willing to bet that the op meant that the a1c has been good since diagnosis... but even if not, the a1c is not a diagnostic tool usually. The GTT and fasting bg's are a much better indicator of diabetes. Think of it this way... if you fail one test, with, let's say a 50, and then make a 90 on the next one, your grade in a class would be about a 70. That doesn't mean you didn't have problems on that first test... it just means that you did well enough on the next one to gain back some points. A1c's are kinda the same way... if you have enough hypos and enough hypers, they will counteract each other and masquerade as normal bg, when in fact the problem is still there.

I tend to agree with Princess Linda. Something is going to kill us, whether it is a complications from D, a car accident, a plane crash, some other illness, or whatever else. Diabetes is not a death sentence, just a wakeup call.

I have to keep looking forward; pondering over whether or not I have doomed myself to die a horrible death from diabetes complications does nothing for my motivation.Though I understand the "test" analogy you made, Moon, it doesn't quite fit T2. T2's don't ever get enough hypos to ever average out to an A1c in the 5's. A1c is indeed one of the principal tools along with FBG to determine T2. At least according to my doc and what I read. I think if you do even a casual perusing of all the signatures here I don't think there's even one where their initial A1c was in the 5's or even low 6's. So my quandary still exists.

[Moonglo]

Though I understand the "test" analogy you made, Moon, it doesn't quite fit T2. T2's don't ever get enough hypos to ever average out to an A1c in the 5's. A1c is indeed one of the principal tools along with FBG to determine T2. At least according to my doc and what I read. I think if you do even a casual perusing of all the signatures here I don't think there's even one where their initial A1c was in the 5's or even low 6's. So my quandary still exists.

I understand that, but as the op-er has already stated, the first a1c was not done until months into the diagnosis. Also, depending on what we are eating to cause the hyperglycemia in the first place, we might still be going low at night... several t2's on this very forum claim to have issues with dawn phenomenon, which theoretically does involve lows while we sleep. And some might have issues with reactive hypoglycemia that don't get diagnosed too... remember that there are several cases yearly where people are misdiagnosed as t2 when it's actually t1 or 1.5 in disguise. Often that is something that is not discovered for years after the original diagnosis. Based on that information, I think we are jumping the gun a bit by assuming that someone does or does not have diabetes just because of their a1c, and the op here is living proof of that.

[Lloyd]

What they DID find, is if you are T2, and you have had diabetes for 20 years or more, then starting tight glucose control at that point does not help.

Can you spell "Damage already done?"

In all other cases it helps.

-Lloyd