Q: I have a girlfriend who has juvenile diabetes. She is 21 years old and has been a diabetic for the past 9 years. I really love her a lot and want to spend the rest of my life with her. But my family members are dead against this. They are giving many reasons why I should not go for it like she will go blind when she is 30-35 years old, she can lose her kidneys or will not be able to walk and that she will not live for more than 45 years. I know that few of the things they say are a possibility. But I want to know if these things are a certainty or they are just exceptional cases? Is there no way by which her diabetes can be cured? Initially she used to take 60 units of insulin a day. Now it has reduced to 50 units. Is this a sign of recovery? I have heard that the pancreas can be transplanted. Will she be alright if her pancreas are transplanted? Is there anyway by which I can convince my mother for allowing me to marry her. Actually I lost my father 3 weeks ago. He was suffering from Liver Cirrhosis and was waiting for liver transplantation. But unfortunately, no one wished to donate the liver. During the last six months he suffered a lot. So now my family members are adding one more point to it, that your dad suffered for only 6 months, but she will suffer for 10-12 years of her life. I really am speechless when they argue. But I am determined to find any and every possible solution if it exists. There have been quite a lot of medical advances. Can you tell me about a few that can help me in this case. And lastly, what is your opinion: Should I marry this girl or not?

A:Your girl friend has type 1 Diabetes Mellitus for many years. In long term Diabetes Mellitus, it affects most of the systems in body specially the eyes, kidneys, nerves, feet and heart. The development of complications depends upon a few factors. Most important is the control of blood sugar. Research has shown that tight control can prevent these complications. So if your friend has maintained tight control and as of today not suffering from any of the complications then chances of her getting the problems which you have listed are minimal and she can have a normal life. We have on record patients surviving till the age of 80 years and above. So if you want to know what is the likelihood of your friend getting these complications then first step will be to get her screened for the complications from a diabetologist/endocrinologist. Simple examinations and lab tests along with an eye examination from a specialist will tell you her status of diabetic complications. In case she has early changes only and if she can maintain a good diabetic control then she can have a long life without these crippling complications. Reduction in insulin is not a sign of her going into remission as she has an absolute deficiency of insulin and needs insulin lifelong for survival. In fact reduction in dose can be a sign of development of kidney disease. As of now we do not have pancreas transplantation available routinely for these patients. This is being done for patients who need a concomitant kidney transplantation. But next decade or so we hope to have some solution in the form of transplantation of only insulin producing cells. I understand that for you this a major decision in life and it bothers you and your family. Before I give my advice to you I would like to know your friends complication status. Last word: life with Diabetes is not a life of compromise. One needs to do some lifestyle modifications to have a long and fruitful life. We have some celebrities worldwide living life with DM successfully.