Friday, April 26, 2013

My Marriage, and My Diabetes

I was diagnosed in 1945, when I was 6. Nineteen years later I married a wonderful lady named Anita. We will celebrate our 49'th anniversary on May 31. We were married in 1964 when very little was known about diabetes. She knew absolutely nothing about it, and she had no relatives or friends with diabetes. There were no meters to determine my BG levels until the mid 1980's. She had to adapt to my having bad hypos and seizures, while keeping her cool and taking wonderful care of me. I knew I could depend on her, and she depended on me. Our love for each other is first rate. At the present time she cooks for me, tells me the number of carbs in my meals, and watches me so carefully. With all the modern day devices and knowledge about diabetes, I have not needed her assistance with lows or highs since I started pumping in 2007. My control is great. The bad lows I had in the past scared her so much that she still has me test during the night at 1 and 4 AM. I don't have bad lows at night now, but how can I say no? She probably saved my life when I was unconscious with lows many years ago. I do not complain, I test at night, and many times during the day to keep her happy. Now I have been type 1 for 67 years and I have good diabetes health. My wife has helped me to be in such great shape today.

In October, 2012, I fell and hurt my head. Bleeding on the surface of my brain was diagnosed, and surgery was performed for subdural hematoma. I recovered from that, but then X-rays on my knees showed that they both need to be replaced. My wife had a very hard time with all that has recently happened to me and she has been very stressed. She was very rundown and developed a bad cough that led to acute bronchitis. She is recovering, but she is having difficulty regaining her strength. We have decided that her stress over my health problems has led to her present condition. I am doing everything I can for her, and we hope that she will be strong again, so she can have a good summer. She loves working in the yard and her flower gardens.

Having Anita for my wife is the best thing I have had going for me during my life with diabetes. 

Saturday, April 20, 2013

Do Artificial Sweeteners Cause Cancer?

Have you heard that some artificial sweeteners may cause cancer? Do you avoid those sweeteners for that reason? 

Studies of saccharin, aspartame, sucralose, cyclamates, and other artificial sweeteners, have not provided clear evidence that they can cause cancer in humans. These studies are reported by the National Cancer Institute at the National Institutes of Health.

In the 1970s a study with rats showed saccharin was linked with bladder cancer. Further study showed this only applies to rats. It was eventually discovered that the amount of saccharin fed to the rats was very large. Smaller dosages proportional to the size of the rats may not have caused cancer. Human studies have not shown any evidence that saccharin produces bladder cancer. Saccharin was removed from the list of human carcinogens in the US, and legislation was passed allowing products containing saccharin. It is still banned in Canada and some other countries.

I started using saccharin in the 1940s, after being diagnosed with type 1 diabetes. Saccharin has not caused me any problems. The product known as Sweet-n-Low contains saccharin in the US, and I have used that sweetener for many years. 

Aspartame is found in many products, and has trade names: NutraSweet and Equal. It was approved in 1981 by the FDA. Tests have shown that aspartame caused cancer in rats, but only when the dosages were very high. It was suggested that aspartame might cause brain and central nervous system cancer in humans, however, this kind of cancer had begun to rise in the US in 1973, eight years prior to the approval of aspartame. The group most affected by increases in brain cancer were people age 70 and older. That group was not exposed to the very high doses of aspartame since it was first introduced. It was concluded that there was no clear link between aspartame and brain cancer in humans. 

I used to use a sweetener called Sucaryl, which contained cyclamates. It was found that cyclamates caused bladder cancer in rats. The FDA banned cyclamates in 1969, but further study showed that cyclamates was not a carcinogen. A petition was filed for reapproval of cyclamates. No final decision has been made, but the FDA's concerns are not related to cancer.

The discussion above involves the possibilities of cancer, but it seems that no currently used artificial sweetener has been proved to cause cancer. There are many reports that certain artificial sweeteners cause undesirable side effects, and some of them have been substantiated. Many people have stated that they have undesirable side effects when they use certain artificial sweeteners. This discussion, however, involves only the possibility of cancer. 

The following link gives a much more thorough report on the studies involved in this discussion.

Tuesday, April 16, 2013

Needles and Syringes,1940's-1960's

My father started giving me shots of insulin in 1945, when I was 6. When the needles were dull, he sharpened them with a "whet rock". We had our own well, and there were lime deposits from the rocks underground. The needles would be coated with these deposits after they were boiled, and they would occasionally become clogged. The opening in the needles was wide enough that we could push a very small wire through and unclog them. When the needles and glass syringe were being sterilized in boiling water on top of our kitchen stove, we would sometimes forget about them, and all the water would evaporate. Then there was a loud pop and pieces of glass would fly all over the kitchen. I don't think we ever got hurt by these flying pieces of glass, but it was a potential danger. Fortunately, we always kept a spare syringe on hand. 

The picture shows a comparison of a 3/4 inch long 26 gauge needle attached to a glass insulin syringe, and a 5mm 32 gauge (5/32 inch) pen needle attached to a Lilly Luxura pen. What a contrast when we compare the 1940's and the present day! I used the 3/4 inch needle during my early years. My doctor had my father inject into my leg or arm muscles at a 90 degree angle. I was skin and bones when diagnosed, so the injections were very painful. It was not necessary to push the entire 3/4 inch needle into my muscle, but most of the needle was necessary to get the needed absorption. Injecting into the muscle caused the animal insulin to be absorbed more quickly. The insulin from pigs and cows was not as fast as the fast acting insulins we have today, so having a faster absorption was helpful. In my early years I had only one injection per day, before breakfast. The animal insulin was a 24 hour insulin.

In 1955 there was concern about the infection caused by the use of glass syringes, and the worlds first plastic disposable syringe called the Monoject, was introduced. Unfortunately, doctors thought it was safer to reuse glass syringes after sterilizing them. In 1956 the plastic disposable syringe we use today was designed. Becton Dickinson did "extensive development trials and tests and in 1961 introduced it's first plastic disposable syringe, the BD Plastipak."

The link below gives more information on the history of syringes.

I was still using glass syringes and long needles from 1945 until the 1960's when disposable needles and plastic syringes became available. There are so many things about my diabetes past that I took for granted back then. I tell recently diagnosed diabetics about my past, and some of them look at me in horror and disbelief.

Thursday, April 11, 2013

What Do You Know About C-Peptide?

C-peptide was discovered in 1967. The first actual use of a C-peptide test was in 1972. In more recent times, C-peptide has been found to have an effect on microvascular blood flow and tissue health.

Type I diabetics typically have very low levels of C-peptide because most of their beta cells have been destroyed. This has been seen in the development of long-term complications such as peripheral and autonomic neuropathy. I have experienced both kinds of neuropathies, but neither type has proved to be particularly problematic after 66 years of type 1. 

C-peptide has been shown to significantly improve nerve and kidney function. It has also been reported to have anti-inflammatory effects as well as aid repair of smooth muscle cells.

"Several physiological effects have been observed in several Phase 1 and exploratory Phase 2 studies in almost 300 type 1 diabetes patients, who lacked endogenous C-peptide. Improvements were seen on diabetic peripheral neuropathy, nephropathy and other decrements associated with long-term complications of type I diabetes. So far, dosing with C-peptide has shown to be safe and there were no effects of C-peptide demonstrated in healthy subjects (who make their own C-peptide)."

"Newly diagnosed diabetes patients often get their C-peptide levels measured as a means of distinguishing between type 1 diabetes, Maturity Onset Diabetes of the Young (MODY), Latent Autoimmune Diabetes of Adults (LADA) and type 2 diabetes."

The pancreas of a type 1 diabetic does not usually produce adequate insulin, so a decreased level of C-peptide is expected. Some secretion can still be present during the honeymoon stage for type 1 diabetics. C-peptide levels in type 2 diabetics are normal, or even higher than normal. Determining the amount of C-peptide in people who inject or pump synthetic insulin "can help to determine how much of their own natural insulin these patients are still producing, or if they produce any at all."

The results of a C-Peptide test can vary from lab to lab. So different labs may have different "normal" ranges. Doctors will sometimes evaluate your results based on your health and other factors. A C-Peptide value that falls outside the normal range may still be normal for you. The C-Peptide and blood glucose levels are measured at the same time to give a better evaluation. 

A normal C-peptide level may be indicated as – Fasting: 0.51-2.72 nanograms per milliliter (ng/mL) or 0.17-0.90 nanomoles per liter (nmol/L)

The 725+ participants in the Joslin Medalist Study were tested for their C-Peptide levels. That test along with a glucose tolerance test showed that more than 66% of these long term diabetics do still produce some of their own insulin. My C-Peptide level was less than 0.1, showing that my good health after 66 years of diabetes has to be explained by factors other than insulin secretion.

"Persons with LADA typically have low, although sometimes moderate, levels of C-peptide as the disease progresses and high blood glucose levels.
The most common MODY syndrome may also have normal fasting C-peptide results because the flaw in this case is in the secretion of insulin in response to rising glucose and fasting secretion is still near normal. Their postprandial C-peptide however is below normal with elevated blood glucose.

Low levels of both C-peptide and blood glucose are found in liver disease, a severe infection, Addison’s disease, or insulin therapy."

I have believed for several years that C-Peptide present in the animal insulins I used for 50 years may have protected me against certain complications. It may help explain the longevity and good health of all the Joslin Medalists. Today's synthetic insulins do not contain any C-Peptide. I have experienced several minor complications since starting synthetic insulins, but none of them have been particularly problematic. I asked Dr. King, head of the Joslin Medalist Study, about this. He said he does not think that C-Peptide is a factor in explaining the longevity and good health of the medalists. Maybe he will have changed his mind when the study concludes. 

The link below is my reference. It discusses C-Peptide in much more detail.

There is a company that has produced an injectable form of C-Peptide. Stage 2 trials have been held, and human subjects have been helped by these injections.