Do you guys go to the Ophthamologist regularly? I go every 6 months sometimes every 3 depending on whether something may be going on in my eye. I have mild retinopathy in my right eye so the moment I feel as though I am having a problem I will always call the doctor to make sure that nothing has changed. What about you?
I go once a year. So far no problems.
My opthamologist is hilarious. He talks super fast and always has students following him who look shell shocked. Most doctor appointments are kind of boring, but his are awe inspiring.
yes, every 4 months or so. I have access to great doctors around the NYC area so finding a retina specialist was easy for me. the important thing, IMO, is a retina exam with the sodium fluorescein and retinography. 1x per year, to check the actual blood vessels, and it wouldn't be worth going if your doctor can't do one right in the office.
What has your A1C been? If your A1C is good do you not get complications?
jess, if you are asking in general, better a1c usually means less complications, but I don't know many people with type 1 who have hba1c below 5.5% and random blood sugars below 140 mg/dl all of the time.
complications can occur with "good" a1c. that's the point of the thread, I think. anyway, I believe it's a good idea to get your eyes checked by a speciaist because retinopathy doesn't have symptoms, until damage has been done.
Jess,
My last a1c was 6.3 if you are asking me. I am not sure if you were. But Joe is right complications can occur with an in range a1c level.
Wow....did you always have an a1c in the 6 range? If you did I cannot believe you got a.complication!
Complications aren't fair and they can't be easily predicted. Being in tight control helps reduce the liklihood, but it still happens.
Then there are people like me. I have a 6.6 A1c now, but for more than a decade had A1cs around 14-15. Not even sure what it was as a little kid, but it was probably high then too. I don't have retinopathy or any other complication. Researchers think some of us are somehow protected from complications. Also, in the Joslin study on people who've lived with type 1 at least 50 years, 3/4 of them still make some insulin. That's a huge help in regulating blood sugar.
There was a 2009 study in the Archives of Internal Medicine that does a good job of explaining.
Basically people who have less tight control have these levels of complications after 30 years with diabetes:
- 50% retinopathy (but 90% of those cases are treatable now)
- 25% nephropathy (kidney disease)
- 14% cardiovascular disease
Those with intensive therapy, who keep A1c below the magic 7.0 have complication rates after 30 years with diabetes of:
- 21% retinopathy (but 90% of those cases are treatable now)
- 9% nephropathy (kidney disease)
- 9% cardiovascular disease
- And fewer than than 1% had blindness, needed kidney replacement, or underwent amputation because of diabetes during the same time frame.
So you reduce your rate of complications if you have fewer highs and lows. But you aren't safe from or definitely getting complications either way.
in my opinion, a1c is a BS indicator of good control and it's overrated and misunderstood. it's an average. how can you manipulate an average? you could have an a1c of 6.8 the reality is you could have had 55-280 all day long. a1c doesn't capture the roller coaster.
a very little discussed issue is with step changes to tighter control. I had no retinopathy until I achieved better control, then new blood vessels started to grow. My specialist believes that high blood sugar causes slow decay of retina blood circulation, a step change to better control could play a part in a trigger for the eye attempting to increase blood flow, by growing new vessels. the new ones are typically the most likely to leak. scary thoughts.