I have researched but could not find much info about DKA occurring long ago in the 1940's and beyond. Common sense suggests 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 must have had DKA much 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, even though I had highs above 250 that suggested possible DKA. 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 deserved 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 a few thousand medalists that are alive, and without any serious diabetes related complications. What makes us different from most type 1 diabetics? Why have we survived those early years, and why did we not die from DKA? 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 eight years, and more than 800 medalists have participated. I participated in 2009. Many interesting results have come from the study. You can read about the Joslin Medalist program and the Study on the link below.