Well-Managed Diabetes is the Leading Cause of Nothing

I have a favorite cup that says: “Well-managed diabetes is a leading cause of _______." I should be clear that it is not intended to be a fill-in-the-blank question. Instead, it’s a statement meaning that well-managed diabetes is a leading cause of nothing.

It’s a distinction that we fail to emphasize enough when we talk about the health risks of diabetes."

Health risks because of diabetes

• Diabetes doubles our risk for heart attack or stroke
• Diabetes is the leading cause of kidney failure
• Diabetes increases the risk for glaucoma by 40% and for cataracts by 60%
• Diabetes reduces life expectancy by 10-20 years

These are just a few of the many common descriptions of the statistics associated with certain “complications” common to people with diabetes. The numbers are accurate, and the “complications” are clearly related to the diagnosis of diabetes when compared to people without diabetes. It’s the story of “what is.”

Reduced risk of complications because of well-managed diabetes

But, there’s another story – another set of statistics – that we perhaps fail to emphasize enough, and it’s the story my favorite cup tells. That story is told most clearly by two studies funded by the National Institute of Diabetes and Digestive and Kidney Disease (NIDDK) – the Diabetes Control and Complications Trial (DCCT) and the follow-up, Epidemiology and Diabetes Interventions and Complications (EDIC) study.

These two studies, spanning from 1983 until 2006, showed that, in very general terms, keeping average blood glucose levels as close to normal as possible had the following effects:

• Reduced incidence of eye disease by 54%
• Reduced incidence of kidney disease by 50%
• Reduced nerve disease (neuropathy) by 60%
• Lowered risk of heart disease and related death by 32% after 20 years
• Most importantly, the participants lived longer – carefully managing blood sugar greatly reduced or eliminated the shortened life expectancy seen in people with diabetes

What’s my point?

The statistics about the risks of diabetes – about complications – are really statistics about the risks associated with how we decide we’re going to manage our diabetes. There aren’t any guarantees, and different studies look at different populations and show different results. However, there is no argument about the importance of taking diabetes self-management to control average blood glucose levels seriously. Just as my favorite cups says, well-managed diabetes is a leading cause of "nothing," and "nothing" is precisely what we want to get from diabetes.