Is 30 the New 20?

I just talked to an old camp pal of mine who is a born-again diabetic after a visit to the eye doc revealed some issues. He mentioned that he's had D 30 years.

It used to be that docs felt that if you'd managed to get thru 20 years with diabetes, complication free, you were not as likely to develop any problems (assuming continued diligence, etc). John's Joslin doc has said this to him more than once. John has 39 years with diabetes, and no complications so far. Nearly half of those years were lived without such fancy things as humalog insulin, and a solid third of those years were spent without home blood glucose monitoring.

Having heard about complications at the 30 year mark from more than one person, I began to wonder if 30 is the new 20. Does 20 years with A1c's in what was considered the acceptable range ten years ago do the same amount of damage as 30 years with tighter control? Studies that show tighter control reduces risks of complications would certainly support this theory.

I like to think that, diabetes-wise, good days buy you more days (or at least make the days you have more enjoyable). But I do know that other factors play into the development of complications. And time, it would seem, is one of those factors.