Early Intensive Insulin Control and Type 1 Diabetes
A recent study showed that intensive insulin control (keeping hemoglobin A1c at or below 7.3) early in the course of Type 1 diabetes, lowers the long-term risk for impaired glomerular filtration rate (GFR) which is a predictor for end-stage kidney disease. Impaired GFR is also a risk factor for cardiovascular disease and death.
(Source: Medscape.com article.)
Type 1 diabetes, as with any newly-diagnosed chronic condition) is sometimes difficult to gain tight control over initially, because:
- the long-term problems are denied (“That couldn’t possibly happen to me.” Or, “That’s could happen after such a long time, why should I worry about it now?”)
- information over-load, leading to lessened compliance
- denial of diagnosis (“Nope, that can’t be right. I must have something else.”) A variation on long-term denial.
- difficulty modifying medical regime into lifestyle (i.e. not being able to adapt insulin dosage for food or activity, unexpected/unexplainable high or low blood glucose and not knowing how to adjust for this). Patients/clients really need to know that some aberration is ok, but to aim for the tightest control that they can.
