long term diabetes

[olga458]

I have had type 2 diabetes for over 25 years, I was diagnosed in my late 30's. I managed my sugars with diet and exercise for 7 years and then started on diffferent meds. I also have high blood pressure, which I had before the diabetes. I now have CKD for about eight years. I am wondering if insulin should have been started right away although my sugars for fairly well controlled and HBAl c was also within a good range. I believe the blood pressure could have been fluctuating quite abit over the years. I am on an ACE inhibitor to protect my kidneys and blood pressure. Is this a long term result of having the type 2 diabetes, (progression) My function went as low as 48.

[Zoelula]

I'm not exactly clear on what you're asking, Olga. There is a school of thought that says that Type II diabetes should be treated with insulin earlier in order to slow beta cell death, but it is not proven and few docs will do this, especially when someone is having good results with diet and exercise or the addition of oral meds. I don't know what CKD is or the other situations you mention and wonder if you see an endo to look at the big picture of the different things that effect you medically?

When you ask about long term result of having Type 2 diabetes, kidney damage is definitely a possible diabetic complication. However diabetic complications and progression of Type 2 are too different things. Complications occur when diabetes is NOT well controlled. They take place over a period of years of having high NOT LOW numbers so I'm confused when you say your "function" went as low as 48. If you mean your blood sugar, low blood sugars are both unpleasant and can be dangerous, but they don't cause complications unless they are overtreated and lead to frequent highs. It is possible to have diabetes of any type for years and years and not suffer any diabetic complications at all if the numbers are well controlled for the most part.

Progression is another story. I'm assuming that after 25 years you are on insulin? This is a common progression of the disease, though not inevitable and universal.