Saturday, May 12, 2018

DKA and Type 1 Longevity

DKA and Type 1 Longevity
Several years ago I researched but could not find much info about DKA occurring long ago, in the 1940's and beyond. Common sense suggested that there had to be a lot of deaths due to DKA back then. There were no meters that allowed us to test at home, and urine testing was totally unreliable. Animal insulin that was injected once per day certainly did not make carb counting and basal/bolus control possible. My first meter was purchased in the mid 1980s, about 40 years after my diagnosis. My numbers were awful, and most were in the upper 200s and lower 300s. I might have had DKA some of the time. So how have I survived through those years? I did not know about carb counting until the late 1980s, and I did not start basal and bolus insulins until the mid 1990s. So that was about 50 years of poor control due to lack of the necessary devices, insulins and knowledge.There had to be many deaths resulting
from DKA in the early years. I never heard about DKA
(diabeticketoacidosis) until the new century, and I never tested for it until 2007. I think that those of us diagnosed that long ago, who are still alive and with good diabetes health today, must be blessed! I don't know how I managed to survive and stay healthy, but I did, and so have many others among the Joslin medalists. They receive medals for 50 and 75 years of living with type 1. There are almost 6000 people who have received the 50 year medal. and most of them are alive, without any serious diabetes related complications. What makes us different? Why have we survived those early years, and why did we not die from DKA back then? This question is what Dr. King and his research team are addressing at the Joslin Diabetes Center. The Joslin Medalist Study has been running for thirteen years, and more than 1000 medalists have participated. I participated in 2009, and again in 2017. Many interesting results have come from the study.
The above discussion was posted several years ago. A friend replied to my post. She had access to much of the information I was lacking. Here is her report:
From Brie Jontry:
"There is a HUGE span of time and circumstance between having ketones and going into DKA (a drop in blood pH so significant that the blood becomes acidic). For DKA, there has to have been a sustained absence of insulin for a lengthy period of time (I've read that LARGE ketones must have been present for at least four hours--so small-to-moderate would have been present even longer than that--for blood to reach the point of acidosis).
While you likely had small-moderate-large ketones growing up, from time to time, you weren't in DKA for a sustained period. If so, you would have died!
A BG of 250+ also doesn't necessitate ketones. It can come from poorly counting carbs, or other factors, but in the absence of illness and so long as there is *some* active insulin on-board, chances of developing ketones from high BG alone isn't likely.
Here is an article from Dr. Ponder explaining the difference between DKA and ketones:
A quote from Wikipedia on Diabetic Ketoacidosis:
"DKA is a medical emergency, and without treatment it can lead to death. DKA was first described in 1886; until the introduction of insulin therapy in the 1920s, it was almost universally fatal. It now carries a mortality of less than 1% with adequate and timely
"DKA is the most serious hyperglycemic emergency in patients with type 1 and type 2 diabetes mellitus, and is associated with significant morbidity and mortality. The mortality for DKA before the discovery of insulin was greater than 90%. This was dramatically reduced in subsequent years to less than 50% and was further reduced to less than 20% with the incorporation of antibiotics and forced hydration into the therapeutic armamentarium. In the 1950s, the mortality of patients
with DKA treated with high doses of insulin was reported to be less than 10%. In more recent years, the use of standardized written guidelines for therapy has resulted in a mortality rate less than 2%, with higher mortality observed in elderly subjects and in patients with concomitant life threatening illnesses."
Now I know much more about DKA, past and present, how about you?

Thursday, November 2, 2017

Blue November, Diabetes Month

    November is the official month for diabetes. Blue is our color, and JDRF is our organization. Let's make type 1 become type none!
    Type 1 for 72 years, but looking forward to new horizons, new technology, and a brighter future for all people with diabetes.

Saturday, October 21, 2017

Low Carb for Type 1?

Low carb for type 1?
I am type 1, diagnosed in 1945. I knew nothing about an appropriate way of eating. My doctor told me to take my insulin before breakfast and to avoid sugar, but there was no other advice given back then. I could eat anything I wanted, and as much as I wanted, if it did not contain sugar. I lived on a farm, and there was soooo much to eat. I drank milk from our own cows with every meal. We had an orchard with many kinds of fruit, and an acre of garden space. I ate tons of carbs every day, but I did not eat sugar, so my parents thought that was OK.
There was no device for testing my blood sugar until the mid 1980's. I survived and thrived that way for 50 years until the 1990's. I started testing my blood sugar with a glucometer, and before the dawn of the 21'st century, I was counting carbs and using a fast acting insulin. I began gaining weight. I had never been overweight until then. I was diagnosed with insulin resistance in 1998. Yes, type 1 diabetics can have insulin resistance. I started taking oral meds for the insulin resistance. With Metformin, eating an average of 130 carbs per day, and getting a lot of exercise, I lost all of the extra weight. My A1c's were in the high 5's and everything seemed good, but then I started having diabetes complications. Retinopathy and neuropathy were diagnosed. The roller coaster control, with too many highs and lows gave me a good BG average and A1c, but the complications were there.
I started using a pump in 2007. There were fewer highs and lows. My diabetes management improved so much that the retinopathy disappeared, and the neuropathy was not much of a problem at that time. My A1c's have remained in the 5.4-6.4 range for about 15 years. I am averaging 150 carbs per day, and I am not overweight. I am obviously not following a low carb diet, but my diabetes management is good. I am using a pump and a CGM, and my complications are under good control. Why should I follow an even lower carb diet? There are many type 1 people following a very low carb diet but I don't think a low carb is necessary for all diabetics. What do YOU think?
The following link gives an article written by Sysy Morales on It asks the question "Should all people with diabetes try eating low carb?" There are 50 replies to the article.

Thursday, October 12, 2017

Type 1 Diabetes 1900-1950

Dr. Joslin's article, Type 1, 1900-1950
Dr. Elliott Joslin wrote the following article in 1950. It gives a report on Type 1 diabetes for the years 1900-1950. It is very interesting to be able to compare the now with the then while reading this article. The first 21 years covered by the article were before insulin was discovered.Type 1 diabetics, and others, should find the article very interesting...rather startling, too!

Monday, September 25, 2017

Type 1 Diabetes Study

I was diagnosed in 1945, and I have been type 1 for 72 years. I do not have diabetes related complications, except for some neuropathy. How is that possible? I don't know. It could be good genes. My last name has Celtic and Welsh origin, and there are many Vaughn's in Ireland. Maybe my good fortune is the luck of the Irish. 
There is a Facebook group called "The Joslin Medalists". It is a secret group. (Shhhh, don't tell anybody!) All the members there have been type 1 for at least 50 years, and they have Joslin 50 year medals. There are more than 5000 people who have been awarded that medal, and a great majority of us do not have any serious diabetes complications. We can't all be Irish, so there must be some other explanation. lol
The Joslin Medalist Study is attempting to find the factors that have enabled us to have type 1 for so long, without serious complications. Dr King, head of the study, in Boston, says there is some kind of special inner protection that many of us have that keeps our eyes, kidneys and nervous systems healthy. Many of you type 1 people here are very likely to have that inner protection, too. Dr. King also said that our hearts do not benefit from that protection, so he advised us to take very good care of our hearts!
Some progress has been made on pinpointing this inner protection. The study, 2005-2017, has thoroughly examined 1020 medalists. I participated in 2009, and again in June of this year. In the days ahead I am going to post some of the results found with this study.

Wednesday, September 13, 2017

Thursday, September 7, 2017

Lilly the Insulin Doll

Have you heard of Lilly, the insulin doll? In the early 1920s the Lilly insulin company supplied free insulin to a group of children being cared for by Dr Elliot Joslin. At Christmas time, the children thanked Mr J K Lilly for the gift of the life saving insulin by sending him a personal letter. Mr Lilly was very touched by the letter, and he sent each child a new doll, and a new insulin kit. Each child named their dolls Lilly. There is a picture below showing Dr Joslin with one of the children.
The doll shown was created to celebrate the 77'th anniversary of the discovery of insulin. I could not find a picture of the original doll sent to the children by Mr Lilly.
There was also a much more recent attempt to have a "Diabetes Barbie" doll created. One of my Facebook friends was successful in getting that done. You can google "Diabetic Barbie" and see the result of that attempt.