Friday, July 12, 2019

Double Diabetes

There were no diabetes "types" when I was diagnosed in 1945. All people diagnosed with diabetes were treated with insulin taken from pigs and cows. That crude form of insulin gave me back my health. In the years 1936-1939 it was discovered that there were two types of diabetes, but it was not until 1959 that the labels Type 1 and Type 2 were attached. Oral drugs for Type 2 diabetics were introduced in the years 1955-1956.
Now, in current times, we are seeing more and more people with
characteristics of both type 1 and type 2 diabetes. These individuals have "double diabetes". This occurs when:
1. A person with type 1 diabetes becomes overweight and develops the basic feature of type 2 diabetes – insulin resistance (IR). Typically, the type 1 diabetic would then use a type 2 medication to help control the IR. Insulin would still be necessary as well.
2. A person with type 2 diabetes has one of the key features of type1– the presence of antibodies in the blood against the insulin producing beta cells of the pancreas causing a decrease in the body's ability to produce insulin. The decreased insulin production can then lead to the type 2 diabetic becoming insulin dependent. These individuals still use their type 2 medication for their IR.
"The term ‘double diabetes’ was first coined in 1991 based on the observation that patients with type 1 diabetes who had a family history of type 2 diabetes were more likely to be overweight and rarely achieved adequate glycaemic control even with higher insulin doses. The more extensive, or stronger, the family history, the higher the dose the patient received."
Double diabetics may have initially been either type 1, or type 2. Once they have become double diabetics they have IR, they are using insulin, and they are using a medicine (usually metformin) for their IR. I have several type 1 friends, and type 2 friends, who are double diabetics. Some of my type 2 friends are using a pump and a CGM.
In the 1990s I stopped using animal insulins, and began using synthetic insulins. I began gaining weight, even though I was following a much healthier diet, and eating fewer carbs. The only thing that had changed was my insulin. I have read many reports that say the synthetic insulins cause our cells to store fat. Maybe that was the reason for my weight gain, but I did not know that information until much later. I had never been more than five pounds above my ideal weight (185) until the 1990s. By the year 1997 I weighed 242 pounds. That was a net gain of 57 pounds. A lower carb intake and plenty of exercise did not seem to help at that time.
Finally, in 1998, I was diagnosed with insulin resistance. I had several relatives with Type 2 diabetes, and it seems likely I was predisposed to become type 2. The predisposition and the weight gain are likely the explanation for my insulin resistance. In the early 2000s I reduced my daily carb intake, increased my amount of exercise, and lost 34 pounds. I initially used avandia for my IR, but started using metformin in early 2011. Using metformin for one year was very good for me. That medication has helped many diabetics lose weight. I lost an additional nineteen pounds, and was only four pounds above my ideal weight. Despite the weight loss, I still had IR. Metformin, eating an average of 140-150 carbs per day, and getting lots of exercise kept me in good health. My A1c's were typically below 6.0, and except for some neuropathy, I do not have any diabetes complications. Double diabetes can be controlled, and my health is just as good now as it was before I became a double diabetic.
A type 1 diabetic with IR has double diabetes, but is NOT both type 1 and type 2. That person is type 1 with a type 2 characteristic. That is not the same as having both types of diabetes.
If you are type 1, you gain a substantial amount of weight, and you have type 2 relatives, you might want to discuss your situation with your doctor. You may have insulin resistance. You may have double diabetes.

Tuesday, July 9, 2019

My Story on Diabetes Mine

In the year 2015, Mike Hoskins published a blog on Diabetes Mine about my life with type 1 diabetes. I sent the article to Mike, and he edited it, including pictures, and a reference to my book. Here is my story on DiabetesMine.com

Wednesday, July 3, 2019

Finding The Right Lady, Our Marriage


I was teaching at Bridgewater College in 1963, in Va. I had a little black book with names of coeds that I had picked from the 1962 yearbook. I showed the list to my dorm mother friend. She looked very carefully at my list and said date this one, her name is Anita, she is wonderful, and forget about the others. That was not my plan, but I agreed to give Anita a call. After a few dates with Anita I was not so interested in calling any more girls, so I just stuck with Anita and Wanda. I dated Wanda on Friday, and Anita on Saturday, Sunday, Monday,..... I guess the dorm mother had hit the nail on the head. Anita was different in a very positive way. Beautiful, so sweet, and I felt very comfortable with her, like I had with Mary Louise. I looked for that little black book one day, and it was gone. I have wondered if the dorm mother had cleaned my room one day. saw my list, and threw it away??? She really did like Anita. I DID TOO!!! I stopped dating Wanda, and Anita and I were going steady. Anita eventually told me that the girls at her dorm had helped her fix her hair, pick out the dress she wore, etc before our first date. I think the whole campus knew we were dating. At that stage I was even dating her on Fridays. Dating every day of the week. I wonder if any other couple ever did that.
I took Anita home with me for the Thanksgiving weekend. Mother loved Anita! Daddy did too! Hey, this is getting serious here!!! Anita and I had already admitted our love for each other. When the semester was over I went home for Christmas, and Anita went to Falls Church, Va to be with her family. It was agreed that I would go to Anita's house the day after Christmas so I could meet her family. Late on Christmas Day a terrific snow storm hit Roanoke. The roads were plowed late the next morning, but the driveway at our house had about 18 inches of snow. My parents insisted that I stay home, and wait to see my sweetie when the spring semester began. They were out of their minds!!! I shoveled the driveway, and packed my car while Mother was screaming at me. I started up the hill on our driveway. Too much ice, it was bitter cold. My tires were spinning, and Daddy helped me put chains on the rear wheels. I still could not make it up that hill. I was about to give up when I saw daddy coming with his tractor. He pulled my car up the hill to the road, and off I went. The roads between Roanoke and Falls Church, Va. were slick and dangerous, but nothing was going to stop me. It took me about six hours, normally it would have been four hours. I found her house, and I met her parents and her brother. Nice people!
That evening we went downstairs to the rec room where there was a fireplace, all warm and cozy. I proposed marriage that evening, and she said yes!!! HURRAY! Months later her Mother said she knew that we were engaged, she could tell by Anita's grin as we walked up the steps. We were going to keep it secret for awhile because we had been dating for less than two months. We planned our wedding for May 31, 1964. We were married after 7 months of courting. We celebrated our 55'th anniversary on May 31, 2019. We have had a wonderful marriage, still going strong!!!
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Anita read this chapter after I finished writing it in 2010.. She proofread all my chapters. She said it was to find misspelled words and grammatical errors, but I know she had other reasons as well. She was an English major in college.
She laughed all the way through this chapter.
The first picture below shows Anita when she graduated from high school in 1962. The second shows us with our firstborn, David, 1966.


Friday, June 21, 2019

Wednesday, June 19, 2019

Diabetes and College, 1957-59

Diabetes and College, 1957-59

My parents told me I could not go to college. They thought I would not be successful because of my diabetes. None of my relatives had ever gone to college. Many of them had good jobs and good salaries They lived in fine homes. My parents did not understand my being so obsessed with going to college. What they did not understand was that I was deeply hurt by their telling me I would not make it through college because of my diabetes. I wanted to show them I could do that, and do it well! I had a good mind, and I wanted to use it in a meaningful way.

They begged me to apply for a job at the post office where my father worked. I could become a post office clerk, and he could watch over me. So I had to choose between standing at a counter selling stamps and weighing packages, or going to college. The only coed college available was Roanoke College, just 20 minutes away. If there had not been a college nearby I would never have gone to college. My parents were disappointed in me, and Mother cried. They were so dead set against my doing this.They refused to pay for any part of my tuition or my college expenses. They were kind though, and they gave me free room and board. Daddy let me drive his older Chevy instead of trading it in when he bought a new car. He kept the car in good shape, and paid for the gas. I had no money of my own, so I had to get a job. I started working at a supermarket the very month I graduated from high school. I worked about 30 hours per week during the summer, and started off at 75 cents per hour. Every few months I would get a raise of 5 or 10 cents per hour. I saved enough to pay for half of my tuition for the fall semester. I was supposed to pay the other half later during that semester. College expenses were so much more reasonable back then. If someone was working at a grocery store to pay for tuition in the 21'st century, it would be impossible. My being able to live at home, and make enough money to pay tuitions, made it possible for me to go to college. I reduced my hours at the grocery store when college was in session.

I wanted to become an architect. There was a pre-engineering program at Roanoke College, and I chose courses that would enable me to transfer after two years to Va. Tech, to become an architect. I made all A's and B's (mostly A's) during my freshman year, except for chemistry. I was not ready for college chemistry. I talked to the chemistry teacher and she understood my problem, but she could not do anything for me. I received C's in both semesters of chemistry, but I knew almost nothing about chemistry when the spring semester ended. Not having had the high school prerequisite chem course made it almost impossible for me. I felt the C grades were a gift. I was very grateful, but I felt guilty about it. I made new friends while in college, and we visited each other's homes. We played golf and went bowling many times. Good friends. I had a crush on several girls while in high school, and during my freshman year of college, but I was too shy to ask them for dates. I had my first date during my sophomore year of college. My shyness and lack of confidence kept me from dating until then.

While in college, I continued with one shot of animal insulin each day. I had Test Tape for testing my urine. That was so much better than the test tube and boiling on a stove. There were no glucose tablets for a long time to come. Sugar worked very well. I remember having lows during tests, and my teachers never let me take a make-up test. I took my test with my class, or not at all. I had a low during a calculus test that was so bad that my vision was blurred, and I could not read my test paper. My teacher would not believe me. That was the only math test I failed in college. There were only three tests and a comprehensive final exam in each math course I took. My failing grade on that test resulted in a B grade for first semester calculus. I made A's on all of my other Calculus tests.

When I returned to campus for my Sophomore year the pre-engineering program had been cancelled. I had engineering drawing, engineering orientation, and a class in slide rule during my Freshman year. (Can you believe that? There were no computers back then, and slide rules were very popular. I carried it strapped to my belt for my Freshman year. I still have my slide rule in a closet today.)

Since the pre-engineering program was cancelled, I could not continue my preparation to become an architect. It was too expensive for me to commute to Va.Tech, even though the campus was only one hour away. I needed to stay in Roanoke and work at the grocery store so I could continue paying my tuitions at Roanoke College. I had to change my major, and give up the idea of becoming an architect. I had always loved math in high school, and during my first year in college. The head of the math department convinced me to change my major to mathematics. I was disappointed that I could not continue to prepare for becoming an architect, but it all turned out well. The wonderful things that happened in the years ahead would not have happened if I had continued my original major on another campus. My mother was pleased that I would continue for four years at Roanoke College, while living at home.

I dated a very nice girl named Linda during my Sophomore year. We dated many times, and I really liked her. I will continue with that in my next chapter.


Saturday, June 15, 2019

School and Type 1....1945-1957


One shot per day, one urine test, large portions of food, and no worries. We did not know there was any potential problem, and I led a rather normal day to day existence. Ignorance was bliss!! There were no health problems with my diabetes throughout my childhood, despite my very irregular blood sugars. I have often wondered why I did not have DKA back then. Was something protecting me? All the fast acting carbs I ate each day, without correction boluses like I take now, must have kept my blood sugar very high. The only times I had lows and hypos were when I got too much exercise, and sometimes during the night. My insulin was working during the night just like it did during the day, but without food. That would sometimes give me lows and seizures while I was sleeping, if I did not eat enough before bedtime.
My parents did the best they could for me during my childhood. Dr. Davis gave no instructions that helped. My parents raised me in much the same way that they were raised in their mountain homes. They did not drink, smoke or swear. They were good Christians, and kept to themselves. They bought land outside the Roanoke, Va. city limits so they could have a farm. They were raised on farms, and they loved that kind of living. That had a lot to do with the way I grew up, the development of my shyness, and my overall personality.
My mother wrote her own story when she was in her 80's. She only briefly mentioned my diabetes diagnosis. She did not say anything about the months leading up to my diagnosis, or the trauma in the months that followed. My parents were devastated by my diabetes, and not knowing how to care for me. The memories were probably too painful for her, and she chose not to include those details in her story. It is impossible for me to remember all that happened back then, but my parents told me all the details years later.
I was not a very good student during my first few years of elementary school. I made a lot of C's but I never failed a grade. I studied hard,and my Mother was a great help. She was a good tutor. I had hypos during the night about once per week, and then ran high blood sugar during the day. All those carbs caused the highs. Mother was afraid I would have a hypo while at school. She approached the teacher at the beginning of each year and explained my condition. She said I should not exercise like the other kids. She convinced Dr. Davis to write an excuse before school started each fall. I never participated in play period or gymnastics of any kind. I sat and watched the other kids. Mother would not have it any other way. My classmates knew I was different, and they ignored me but never made fun of me. I tried to make friends, but I was never very successful. I became very withdrawn, and terribly shy. I hated my diabetes, and blamed it for my misery in school. I never blamed my Mother because I also feared having a hypo in school. Mother always brought me out of my hypos at night by feeding me water containing a lot of sugar. I knew there would not be anyone to do that for me at school, so I sat and watched the kids play, and felt comfort in knowing I would not have a hypo. I would have been so embarrassed if I had had a hypo at school. I never did have a hypo in grades 1-12.
By the time I reached fourth grade I started making better grades. In the sixth and seventh grades I made several A 's and B's, not many C's. I was always the best in my class at spelling. I took great pride in my ability to spell complicated words. When I reached high school my Mother still wanted me be excused from gym classes. I was rather good at basketball, at home. Daddy nailed a barrel hoop to the side of the corn crib, and I became very good at making baskets. I played and worked hard at home, but always under Mother's watchful eyes. I still had that fear of having hypos in high school, so I agreed to not participate in gym classes. I wish now that I had rebelled and taken gym. I was still withdrawn and shy in high school. I made a few friends though and my grades were very good. I graduated number 13 in high school in June, 1957. My math teacher in my senior year found that I was not intending to go to college. She begged me to go. I considered it but I knew my parents would not approve.
My parents told me I could not go to college. They thought I would not be successful because of my diabetes. None of my relatives had ever gone to college. Many of them had good jobs and good salaries They lived in nice homes. My parents did not understand my being so obsessed with going to college. What they did not understand was that I was deeply hurt by their telling me I would not make it through college because of my diabetes. I had to show them I could do that, and do it well!
The picture below is my senior year picture in high school.

Sunday, June 9, 2019

Misdiagnosis of Adult Diabetics

I have read so many times about adults being diagnosed with T2D when they are actually have T1D. Here is a quote from a very good article on this topic.

"People with adult-onset Type 1 diabetes/LADA who are misdiagnosed as having Type 2 diabetes are wrongly treated as though they have Type 2 diabetes.  Consistent evidence shows the importance, in terms of clinical outcome, of early initiation of insulin therapy in Type 1/LADA.  Thus, the early clinical recognition of people with adult-onset Type 1 diabetes, as distinct from Type 2 diabetes, is extremely important to guarantee the most suitable treatment in order to preserve beta-cell function, gain optimal metabolic control, and improve long-term outcomes.  A correct diabetes diagnosis is the cornerstone of correct therapy and a wrong diagnosis delays achievement of optimal metabolic control, frustrates patents, and increases the risk of life-changing or fatal complications."

The link for the complete article appears below:

http://adultt1diabetes.blogspot.com/2019/06/getting-it-right-for-people-with-adult.html?utm_source=feedburner&utm_medium=email&utm_campaign=Feed%3A+AdultOnsetType1Diabetes+%28Adult+Onset+Type+1+Diabetes%29