Theoretical question.

[handsome]

Hi,

I have a theoretical question,

If someone never cared for their diabetes (or cared very poorly), how long would it take (on estimate) before complications kick in?

1)kidney's 2)feet 3)eyes 4)heart 5)stroke

and which one of these usually come first?

[JDRF-Team-sgg]

It truly depends on tne individual. Some people have one complication happen first, while others have another. Some live their entire lives without any complications at all.

Many of the folks who write to us at the Juvenile Diabetes Research Foundation tell their stories and the variety is amazing. Some develop eye problems quickly -- I know of a few whose diabetes was not even diagnosed when eye problems caused doctors to check their glucose levels and find that they were diabetics (so they perhaps developed the eye problems even though they probably were uncontrolled diabetics less than a year). Others take years of poor control to start having problems. Some who have complications have neuropathy but nothing else is wrong. Others develop kidney problems but none of the other problems. And of course the heart problems or stroke can be the very first sign of complications. Some people develop problems in several of these areas while others only develop complications in one area. I think the amazing mystery of the human body is that we are each so very different that we really cannot predict exactly what will happen.

Interestingly enough, some people develop complications even though their control is pretty good, while others can have fairly poor control and never suffer complications at all. There does seem to be some still-unidentified genetic makeup that seems to protect some people from developing complications while others seem to get them while trying to maintain good control that is by the book.

Studies HAVE shown that tight control DOES protect the diabetic from complications, no matter whether the diabetic person is one of the genetically "lucky" people or not. So while we cannot PROMISE a life without complications if a person maintains tight control, the odds are definitely much better if they keep the sugar levels in the normal ranges. The fact is that the damages are all caused by elevated glucose levels that damage tiny blood vessels nourishing nerves and organs. So if elevated glucose levels are a rarity, then damage is fairly unlikely to happen.  We do not get these complications because something is magically wrong with us because we are labelled diabetics. We get these complications when glucose levels are high for extended periods of time.  

Many of us long-timers grew up in the days before the invention of glucometers. Many of our peers developed complications because of the years we lived with a diabetic condition whose control was at best complete guesswork. Others of us seem to not have any complications at all even though by all we know today we SHOULD be damaged.

I truly beleive that young diabetics today will discover when they are in their middle years, as I am, that many of their peers will be undamaged because maintaining good control is so very possible today. It will of course take a generation of record-keeping to see what kind of rate of complications exist for generations in the modern age. If some of us older folks have managed to live complication-free even without the benefit of the ability to maintain good control, then I think we shall see many more in future generations living until they are in their 80's or 90's.

I am afraid that I have basically answered your very good question with a non-answer. Each person is so very different that I don't think there is a  rote answer to this question.