Question: How important is blood sugar control in affecting the severity of complications related to diabetes?
Answer: So we know that tight glucose control is extremely important in preventing the development and progression of diabetes complications. There are two types of diabetes complications: the small-vessel complications and the large-vessel complications.
There are three primary small-vessel complications. They include retinopathy, which is eye vessel damage which can lead to blindness. The second small-vessel complication is nephropathy which is kidney disease and can lead to a need for dialysis. And then, the third complication is neuropathy, or nerve damage, which overtime can increase the risk of amputations.
We know from two large studies that patients with both type 1 and type 2 diabetes that tight glucose control can prevent the development as well as the progression of these complications. What tight glucose control is, is maintaining a hemoglobin A1c of less than or equal to 7 percent. That number gives a three-month average of the blood glucose over time, and corresponds to an average glucose over three months of about 150 or less.
The large-vessel complications of diabetes include things like heart disease, stroke, and disease of the peripheral arteries. It's still unclear whether or not tight glucose control prevents the development and progression of these complications. There are current studies ongoing that will elucidate this information over the next five years.