Tuesday, March 27, 2012

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 type 1 – 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.

So 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 had the Type 2 gene. The gene 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 starting in early 2011. Using metformin for one year has been very good for me. That medication has helped many diabetics lose weight. I have lost an additional nineteen pounds, and am presently only four pounds above my ideal weight. Despite the weight loss, I still have IR. Metformin, eating an average of 140-150 carbs per day, and getting lots of exercise is keeping me in good health. My A1c's are typically below 6.0, and except for some mild nerve damage, 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. 

Friday, March 23, 2012

Commitment

In the 1945-1988 years I had only one rule to follow. Don't eat foods containing sugar. My doctors never mentioned carbs. I was very committed to following that rule. I became so used to using artificial sweeteners, that a teensy taste of something containing a lot of sugar was too sweet, and I did not like it. Having only one rule to follow made it easier.

In 1988 I read an article ...in a magazine saying that diabetics should restrict the number of carbs they ate to help keep their BGs lower. That was my first exposure to carbs. Then I found that some carbs acted faster, and others more slowly. I started eating smaller portions of the foods with faster acting carbs. There were more rules to follow, and things became more complicated. Then there was using a meter, basal and bolus insulins with carb counting, and my insulin pump. Things were very complicated then. It was so much simpler in my early years to just avoid sugar. It was hard to be committed to having tight control with all these newer rules, and devices to follow. I sometimes wanted to just drop everything and go back to the old ways. I had no complications despite all the high blood sugar I must have had during my first 40+ years, so convincing mtself to follow all the new rules and use the new devices was difficult.

I did not know any other diabetics until I joined some diabetes websites, in 2006. That was 61 years after my diagnosis. That turned things around for me. I met so many diabetics like me, and saw they were struggling with the same problems I was having, or had previously experienced. There were so many not taking good care of themselves, and having diabetes related complications. I could feel myself becoming more and more committed to having really great control. I had always worked hard to have good control, but my online experience made me more committed than ever before.

My commitment has led to my having 66 years of type 1 with no complications except some minor nerve damage. I am very fortunate that having only the "no sugar" rule for so many years has not caused me major problems.

I am definitely committed to being committed. Perhaps diabetics who are not committed should be committed to a ......umm......to online diabetes support groups! ;)

What does committment mean to you?

Wednesday, March 21, 2012

Longer Lives For Type 1 Diabetics

At the present time, people who are diagnosed with type 1 diabetes in early childhood, have a life expectancy comparable to that of non diabetics. The wonderful improvements in diabetes management, and the devices that are now available have made this possible. Here is a link relating to this topic:

http://yourlife.usatoday.com/health/medical/diabetes/story/2011/06/Life-expectancy-improves-for-type-1-diabetics/48851072/1

There are many diabetics diagnosed more than 50 years ago who have lived long lives free from any serious diabetes related complications. I was diagnosed in 1945, when I was 6, and I am very healthy. After 66 years with type 1 diabetes I have no diabetes complications except some minor nerve damage.

I attended a meeting of type 1 diabetics in Boston, in June 2011, at the Joslin Diabetes Center. There were more than 100 of us there, and all of us had lived with type 1 diabetes for at least 50 years. There are several thousand type 1 diabetics who have received Joslin medals for having lived with their diabetes for at least 50 years. Almost 700 of them have participated in the Joslin Medalist Study. The purpose of the study is to determine what factors have enabled them to live so long without diabetes complications. If the study is successful, then a treatment might be discovered that will enable recently diagnosed type 1 diabetics to live long lives without serious complications.