By Dr. B Ramya , Diabetology
Once Diabetes Mellitus is diagnosed, doctors stress upon the fact that the HbA1c (sugar control) should be in the best possible range of 6 to 7 percent. This tight sugar control should be maintained at least for the first 10 to 15 years of Diabetes. This is because if the patient maintains excellent sugar control during this initial period of Diabetes, he would remain in good stead throughout his life, even if the sugar control is not so good later on. This is exactly what is called as ” LEGACY EFFECT”.
On account of the Legacy Effect, the body gets so much used to the good effects of an excellent sugar control that later, even if the control deteriorates, it does not suffer any serious complications. Hence all those who want to avoid serious complications of DM, like those pertaining to the Kidneys, Eyes, Nerves, Blood vessels, etc should make use of this Legacy effect .
As age advances, the Insulin-producing ability of the pancreas also progressively declines, as happens in Type 2 DM. So, in the later stages of the disease, even the best possible drug regimen may not give the ideal level of sugar control. However, the Legacy of good sugar control during the initial phase ensures good health in the later stages as well.
Though we have now understood this concept, in certain cases like patients with severe cardiac/renal/hepatic impairment or advanced age at the time of diagnosis of Diabetes, a very tight sugar control is not advisable. So young and otherwise healthy Diabetics are the perfect candidates for tight sugar control and its legacy!