Can diabetes be free of complications if it is well controlled?

The answer is that it can in most cases, but there is no guarantee that it will not happen 100%.

Earlier foreign DCCT studies and subsequent UKPDS studies have confirmed that long-term stabilization of glycated hemoglobin within 7% can significantly reduce the risk of diabetes complications. Many patients with a short course of disease and good control can really avoid complications throughout their lives. I have been following people with diabetes in the community for almost 8 years, and I have met the most typical 78-year-old man. He has been diagnosed with type 1 diabetes for 41 years. He has been strict with himself since he got the disease in his thirties. His glycation is stable between 6.1% and 6.4% all year round, and his blood lipids are His blood pressure is better than that of many middle-aged people without diabetes. The last annual complication screening showed that his fundus, urine microalbumin, and nerve conduction velocity were all within the normal range. Even the doctor laughed and said that his level of control is better than the health indicators of us staff.

However, after so many years of follow-up, we have indeed encountered a few exceptions: There is a 42-year-old type 2 diabetic whose glycation has never exceeded 6.5% in the 5 years since he was diagnosed. Last year, a physical examination revealed a slight fundus microaneurysm. Some people have actually had latent hyperglycemia for several years when they are diagnosed, and their organs have already suffered minor invisible damage. Even if they are better controlled later, there may be slow progress, but this progress is more than ten times slower than that of people who do not control their sugar, and it basically does not affect their normal life.

In fact, there is no need to think that sugar control is useless because of these special cases. It is like holding an umbrella when going out on a rainy day. If you hold it firmly and tightly, you will most likely not get wet. If a violent storm splashes diagonally on your body, you may still get some water on your trousers, but it is better than if you don't block anything and get soaked in the water.

Many people still have a misunderstanding about "good control". They think that as long as fasting and postprandial blood sugar levels are normal, they have reached the standard. In fact, this is not the case. A 50-year-old diabetic patient came to me to complain before, saying that he had stable blood sugar control, but he developed coronary heart disease just 7 years after being diagnosed. I looked through his physical examination report and found that his low-density lipoprotein was above 4mmol/L all year round, he smoked two packs a day, and his blood pressure was always stuck at the critical value of 140/90. These are high-risk factors for complications. Just keeping an eye on blood sugar is really not enough.

Anyway, I have come into contact with so many people with diabetes. I have really kept my blood sugar, blood pressure, blood lipids, and weight stable. I do regular screening for complications every year. I stay up less late and smoke and drink less. Most of them are living a good life. Not to mention complications, I even have less daily headaches and fever than others. I really don’t need to think too scary about diabetes.