According to the theory of hyperglycemic memory, if the patient has ever had hyperglycemia its effect is stored in its epigenetic effects, so even if the blood sugar is later normalized, the ‘stored’ hypoglycemic memory can continue to cause damage. This sounds like a bad hypothesis, since essentially it says that complications arise in the presence of high blood sugar, and oh, by the way, they also occur in the absence of high blood sugar, because of a hypothetical entity we have constructed to save the theory called ‘hyperglycemic memory,’ which carries forward the effects of hyperglycemia long in the past.
Since I have now survived with type 1 diabetes for 51 years, like all current long-term survivors I spent about the first twenty years of the disease with extremely poor blood sugar control, since there was no way to measure it, since the home glucometer hadn’t yet been invented. So my hyperglycemic memory has to be considerable, and a powerful force for causing new complications despite strict blood sugar control.
So what do I do now? Over the last decade, my A1c has been consistently in the 4 range, so my control has been excellent. But the rate at which my complications have been developing or worsening has been faster than ever before in my life. For example, in the first 40 years of my disease I required two laser photocoagulation treatments for retinopathy, but in the last 10 years I have required 4 treatments, because it has been getting worse faster. Since there is nothing else which can be causing this than metabolic memory, unless it is the combination of greater age with even well-controlled diabetes, what use is the strict control I am maintaining now? It doesn’t seem to have any effect whatsoever in stopping complications, and it is both a lot of trouble to maintain and also extremely dangerous in terms of severe hypoglycemic episodes.