Friday, April 27, 2012

The Joslin Medalist Study, 2005-2012

The Joslin Medalists are individuals who have received medals for having lived with type 1 diabetes for 50 or more years. These medalists have not only survived, but have avoided most of the more serious diabetes related complications. This group is a natural for a study that would seek the factors that explain the longevity and good health of so many type 1 diabetics in the US. If these factors can be determined then there might be a treatment devised that could help younger diabetics to also have long healthy lives. So the study began in 2005, and is headed by doctors George King and Hilary Keenan at the Joslin Diabetes Center in Boston.

A different Joslin study in 1981 found that, among people diagnosed with  type 1 between 1939 and 1959, only 48 percent of women and 34 percent of men were expected to live to age 55. Many of these individuals, however, lived on and were free of many of the complications that so often occur among people with diabetes.

An examination of the first 351 participants showed that 43% were free from any serious diabetic eye complications, 87% from kidney disease, 39% from nerve disease, and 52% from cardiovascular disease.

I participated in the study in December, 2010, at which time there had been approximately 500 participants.  I received many pages in the mail requesting information about my past. I supplied information about genetic, environmental, psychological and physiological factors of my first 64 years of living with type 1 diabetes. I was also asked to provide a listing of all my A1c's that had been determined. My doctor provided a list that began in early 1980 and concluded in late 2010. Some of the A1c's were missing from my doctor's files, but the list was accepted, with no problem. When I arrived at Joslin on the morning of my participation, I submitted my list and then went to a room where many blood samples were taken. A glucose tolerance test showed an increasing BG level for two hours. The fact that my BG steadily increased from the 90s to the 300s showed there was no insulin in my body that would lower my BG. Some participants had a decreasing BG during the second hour after the test. This suggested they were producing some of their own insulin. I was then examined for neuropathy, and taken to the eye center where a thorough examination of my eyes was given. Pictures were taken of the backs of my eyes. I received the results of my study several days later. There was mild neuropathy present, but no other complications were found.

For the first 500-600 medalists examined  "...about 40% did not have serious eye disease even after 50-80 years of type 1 diabetes and less than 10% of the Medalists have any kidney problems. From a complications point of view, these findings are very exciting since they showed that 40% of the Medalists have factors or genes, which are protecting the Medalists from developing diabetic eye disease." It was also shown that over 66 % of the medalists who had participated appeared to still produce some of their own insulin, even after 50 or more years of diabetes. Several participants had volunteered their bodies for study after death. Post-mortem studies confirmed that these individuals had been producing some insulin. It seems that many type 1 diabetes patients have protection from beta-cell destruction.  Cells containing insulin were found in all of the 19 pancreases willed to the Joslin study.

There was a meeting of more than 100 medalists at the Joslin Diabetes Center in June, 2011. My wife and I attended and we met many wonderful people. Doctors King and Keenan were the speakers that day.

“We are on the cusp of identifying protective factors for eye and kidney complications,” Dr. King declared. “We’ve made huge progress in the past year.”
It was announced that the number of cases of type 1 diabetes among children less than 6 years old was rising rather rapidly. This was very alarming to all of us. Let's hope that the Joslin Medalist Study will produce some significant findings that will help these children to live long, healthy and happy lives, without serious complications.

The study is funded by the Juvenile Diabetes Research Foundation, the National Institutes Of Health, and private donations.

My wife and I will attend the next medalist meeting in 2013. I am very anxious for that occasion.

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The following links are the references for this blog:

http://news.harvard.edu/gazette/story/2011/06/what-makes-them-special/

http://www.joslin.org/medalist/6268.html

http://www.joslin.org/medalist/Joslin_Medalist_Updates.html

1 comment:

  1. I just did a similar test to what you describe above where they drew blood before drinking a meal replacement drink and then two hours after. It was to try to enter a clinical trial for a low-glucose suspend pump. They were testing for c-peptide to see if I made any natural insulin during that time (I was allowed to bolus and apparently a blood test can tell the difference). I did not produce enough insulin to exclude me from the study but I know of several online friends who have had diabetes much longer than me who did. So interesting!

    I wrote a little about it here - http://momentsofwonderful.com/2012/04/wordless-wednesday-officially-broken/

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