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Why Some May Avoid Type 1 Diabetes Complications

Researchers Say More Than Just Blood Sugar Control May Be at Work for Some Patients
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WebMD Health News
Reviewed by Laura J. Martin, MD

March 29, 2011 -- After years of living with diabetes, complications can occur, including problems affecting the eyes, heart, kidneys, and nerves.

However, some type 1 diabetes ''veterans'' seem to escape many or most of these diabetes complications, according to a new study.

''This study clearly demonstrates and documents that there can be a large number of people who can go a very, very long time with type 1 diabetes and not suffer with dire complications," says researcher George L. King, MD, chief scientific officer at Joslin Diabetes Center and professor of medicine at Harvard Medical School.

The study is published in Diabetes Care.

Explaining why is not simple, however. In the study, being free or nearly free of complications didn't correlate directly with control of blood sugar, King says.

He isn't discounting the importance of blood sugar control. It's shown to reduce the risk of complications. However, his study suggests other mechanisms may help explain the protection from complications he found in some.

Protection From Diabetes Complications

King studied 351 so-called medalists who had received medals from Joslin Diabetes Center after living with type 1 diabetes for 50 years. In type 1 diabetes, the pancreas does not produce adequate insulin to control blood sugar. In type 2 diabetes, the body may not produce enough insulin or insulin resistance occurs where the body does not respond normally to insulin.

Insulin moves glucose into the cells, where it's used for energy.

The participants' average age was nearly 68. They were about 11 at the time of diagnosis.

King's team looked at common complications, including eye problems known as retinopathy, nerve problems or neuropathies, kidney problems or nephropathies, and cardiovascular disease.

They found that:

  • 43% did not have advanced diabetic eye complications.
  • 87% were free of kidney disease.
  • 39% did not have nerve disease.
  • 52% did not have cardiovascular disease.

''Overall, about 20% do not have any eye, kidney, or nerve disease," King tells WebMD.

Role of Proteins

King's team evaluated blood sugar levels in the participants. On average, blood sugar levels were under good control. The average hemoglobin A1c test, a reflection of blood sugar levels over the past three months or so, was 7.3%. Experts often recommend those with diabetes keep A1c at 7% or below.

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