Thursday, December 29, 2016

True Love and Type 1 Diabetes

My wife, Anita, and I were married in 1964. I had been type 1 for 18 years at that time. I was testing my urine, using animal insulin, and did not know about the effect of carbs on my blood sugar. My control was dismal, with many highs during the day, and some terrible lows at night. I had seizures at night several times each year. My wife was only 20 when we married, and she had a very hard time adjusting to my diabetes, especially the seizures. She became an expert while helping me, and she never complained. In the mid 1980s I had my first meter, I learned about carbs, and I started carb counting with a fast acting insulin in the 1990s. My control improved. There were still frequent lows, but no seizures. In 2007 I started using an insulin pump, and presently I have a Dexcom CGM. My control is so much better, and I never need any help when I have lows, because they are not serious lows.
Anita remembers the old times when I needed her help so often. She was so frightened when I had seizures so long ago. She is still concerned that I may have very low blood sugar, even though my control has been so good for more than 20 years. She sets the alarm each night for 1, 4 and 7 AM. I check my BG to satisfy her that I am okay. She cannot sleep unless I am in good shape. She checks with me several times each day, especially before meals, to be sure that everything is good. (I do have some lows but they are not bad ones, and I can easily take care of myself.)
Anita's memories of how it used to be causes her to be this way. I cannot take trips by myself, even for a few hours in the afternoon, without her worrying so much about me. She wants to go with me on those occasions to keep a watch on me. Her being this way really gets on my nerves, but I rarely complain. She probably saved my life several times in the past, so I appreciate her attention, even though it is no longer necessary. I want to attend diabetes conferences, and make other trips without her going with me. She does not like to travel, she loves staying at home. She went with me to the Friends For Life conference in Orlando in 2015, and we are planning to attend the Unconference in October, 2017. I would like to attend more diabetes related meetings, and conferences, including the FFL's in Canada and the UK, but this will not happen. I love Anita so much, and cannot ask her to take all those trips. She loves me so much that she would insist on going with me. Love and a great marriage is wonderful, but I do want to travel more. I will just count my blessings, and take only an occasional trip. <Sigh>

Sunday, December 25, 2016

Ashamed Of Our Diabetes Management?

My wife and I are grieving over the loss of our son, but it is time for us to gather strength, and get our lives back on track. I am starting today with the following blog.
I was diagnosed in 1945, when I was 6. My doctors knew very little about diabetes. There were no T1 and T2 titles back then, there were no glucometers, and I did not know another person with diabetes. It was that way for 40 years until I bought my first meter in the mid 1980s, and then I learned that carbohydrates had something to do with diabetes. I joined an online support group called in 2006, and learned so much from other type 1 diabetics. They taught me so many things that none of my doctors had mentioned. I have tried to give back to the diabetes online community (DOC) by letting people with diabetes (PWDs) know that it is indeed possible to have long healthy lives with diabetes. For me, it is 71 years of type 1, without any serious complications.
I have been reading about people who shame us for having problems with our diabetes management. I have my ups and downs, and some minor complications, but my life goes on, without interruption. People who would shame us do not bother me, not at all. I ignore them, and go on with my life. I am pleased to know so many people in the DOC who have so much knowledge about diabetes, and who help each other in many ways. That makes us strong, and we will stay strong no mater what our critics may say!! :)

Tuesday, December 13, 2016

Lilly Reduces Insulin Prices

This is definitely a good step taken by Lilly. Some people can save as much as 40% on insulin purchases. I hope the other insulin companies will do this, too.

Monday, December 12, 2016

Eva Saxl Diabetes Story

This is a very wonderful story from the Diabetes Health magazine. A man in China extracted insulin from animals to keep his type 1 wife and many other people alive. during war time. The lady gave lectures and helped others.

Monday, December 5, 2016

Diagnosed When Young, or Older?

Is it better to be diagnosed when very young, or later on in life? Experiencing a normal life for as long as possible seems desirable, but then being diagnosed at a later time would seem so devastating while attempting to change so many things, and give up a more comfortable life. Being diagnosed while very young means that a non diabetic life is very short, or almost nonexistent. It is easier for a very young person or child to accept since there is not so much of an established pre diagnosis routine to give up. It does seem cruel, however, for a young individual to have very little experience living without diabetes, before being diagnosed.
I was diagnosed in 1945, a few days after my 6'th birthday. I have only a few glimpses of my life before that time. The doctors back then gave no advice except to not eat sugar. My parents never gave me anything with sugar, and at that age that was ok. My mom made me desserts sweetened with saccharin, and I was pleased with that. Life was much the same as for a non diabetic. In 1988 I learned that carbs had a lot to do with good diabetes management, and in the mid 1990s I started counting carbs with basal and bolus control. That was much more difficult than my previous 45 years. I started eating very small portions of foods with fast acting carbs, and I missed the way I had previously eaten. I sacrificed the way I wanted to eat, to have much better control. My A1c dropped from the teens to the high 5's. Now I am T1D for 71 years, and I have no serious complications. I do not know why I didn't have terrible complications during my first 45 years when I had very high blood sugar. I feel that it was best for me to be diagnosed while young. There were so many young type 1 diabetics long ago who did not survive because the knowledge of how to survive was not so well known. Something protected me, and I am lucky to be alive and healthy now.
Being diagnosed in more modern times is very different. The devices I did not have, and the proper way of eating are now available, but there are so many restrictions that I did not experience. It is my feeling that in modern times a child has a harder time adjusting than I did. The diabetes management is much better, and the chance of having a longer and healthier life is much improved. The knowledge that now exists, however, is so thorough, and there is so much to learn, especially for a child. I had a short list, and adjustment was easier, but children today have a very long list and adjustment is not so easy.
So, what do YOU think about this? If a type 1 diagnosis is going to happen, is it best at a younger age, or much later in life?

Monday, November 28, 2016

Insulin Injections, 1930

We can all be thankful for the present day insulins, devices, and knowledge about diabetes.
This picture was taken in 1930, only nine years after the discovery of insulin. The girl is injecting the animal insulin near her knee, where there is muscle, and very little fatty tissue. There was no fast acting insulin back then, and injecting in the muscle caused the insulin to act much faster. I injected that way for many years, starting in 1945.

Thursday, November 24, 2016

Mary Tyler Moore

Mary Tyler Moore, one of my favorite TV actresses, Type 1. In the link below Mary tells how she dealt with diabetes. In recent years she has had problems with her vision, and is almost blind.

Tuesday, November 15, 2016

Diagnosed in 1922

This is a wonderful post for International Diabetes Month. Ted Ryder, diagnosed when five years old, in 1922, and lived until he was 76. That is remarkable! His correspondence with Dr. Banting is priceless!

Wednesday, October 26, 2016

Diabetic Seizures

The link below gives a very good article on seizures.
I had seizures starting in 1945, the year I was diagnosed. I was 6 years old then. I continued having seizures for many years. I did not have a meter for determining my blood sugar for my first 40 years, and I did not have basal and bolus insulins until the mid 1990s. I had occasional seizures until the 1990s. I was never given a glucagon shot until the 1980s. I am very fortunate to have parents, and later on, a wife who brought me out of those seizures prior to the 1980s. There are some articles that indicate that seizures can cause brain damage, Despite having many many seizures for 50 years, I do not think my brain has been damaged. I became a college math professor in 1963, and I am a healthy diabetic after 71 years of type 1.

Thursday, October 20, 2016

13 Rewards of Exercise

Top 13 Rewards of Exercise...yes, there are 13. Exercise also helps manage your blood sugar. I love exercise, how about you?

Sunday, October 16, 2016

Longevity Of T1D's

People with type 1 diabetes are living much longer. Studies have found that better diabetes care has narrowed the gap between the life expectancy of type 1 diabetics, and non diabetics in the US. Until recently, no one would have predicted that people with type 1 diabetes could have a nearly normal life span. Things ave improved so much. I am 77, with 71 years of T1, and am very healthy. Some T1 people have lived into their 80s, and a few into their 90s. Researchers are busy looking to find out what these people did right. The Joslin Medalist Study is one study that is researching the increased longevity of so many type 1 people.

Tuesday, October 11, 2016

Diabetes Care, High-Tech

Hi-tech diabetes care is nice, but will insurance cover it? If not, can we afford it? I certainly can not!

Tuesday, October 4, 2016

My A1c History

A1c testing was not available until 1976. My doctor started A1c's with his patients in 1980. I was diagnosed in 1945 when I was 6, and I must have had very high blood sugar until about 1988. That is when my A1c's began improving. Now I am alive after 71 years of type 1, and I have no complications except for some mild nerve damage. As part of my preparation for my taking part in the Joslin Medalist Study I was supposed to have a listing of all my A1c's. My doctor was very cooperative, but there are several gaps in the list.The years 1990-1994 were not available. Below are the A1c's that my doc was able to retrieve from his files. I have updated for 2013-2016.
1980...10.6, 9.6, 9.0
1984...9.2, 9.7, 8.9
1987...8.0, 9.8, 10.3
1988...10.5, 7.7, 7.7
1997...6.0, 5.4
1999...6.8, 6.7, 6.5
2000...6.3, 6.1, 5.5
2001...5.8, 6.0, 5.6, 6.0
2002...6.0, 6.4, 6.2, 6.0
2003...5.6, 5.4, 5.9
2004...5.9, 5.7, 5.8, 5.6
2005...5.6, 5.8
2006...5.6, 5.7
2007...5.5, 5.6, 5.7, 6.1
2008...5.7, 5.9, 5.7, 5.6
2009...5.6, 5.8, 5.8
2010...5.7, 5.6, 5.6, 5.4
2011...5.6, 5.7, 5.8, 5.6
2012...6.1, 6.1, 6.0
2013...5.8, 6.1
2014...5.7, 5.6, 5.8
2016...5.9, 6.0, 6.1
Notice the drop from the 10's to the 7's in early 1988. That is when I
read an article in a magazine that said diabetics should follow a low
carb diet. My doctors never told me that. Then in the late 1990s I was permitted to use basal/bolus control. In 2007 I started pumping. My A1c's have been very good during the new century because I finally knew what to do to get good control. I was very successful for several years before pumping too, but using an insulin pump has made good control so much easier.
I took only one injection of beef/pork insulin per day during my first
35+ years. Can you imagine what my A1c's would have been during those years? Those were the years before my doctor started having my A1c's done.
I feel so lucky to be alive and healthy, without serious complications. Is it good genes? The Joslin Study of long term type 1's in the Us has reported that many of the participants are still producing some insulin. Those individuals are insulin dependant, but any amount of insulin produced in our bodies is very beneficial in helping to prevent complications. My C-peptide is less than 0.1, so I am producing almost zero insulin. There has to be some other explanation for so many of us living so many years with type 1, and not having any serious complications.

Friday, September 30, 2016

FDA Approves First Closed Loop System

This is an important step in producing a closed loop system for insulin users, but I have some reservations.
The accuracy of the Enlite sensors could prove to be an important issue with this closed loop device. Many users of Medtronic Enlite sensors have found them to be very inaccurate at times. Some users quit using them, and started using the Dexcom CGM system. I found these dissatisfied people in the Tandem T-Slim facebook group. They started using the Tandem pump because it is integrated with the Dexcom CGM, and now they are very pleased with the switch. I have read that some people are having success with the Enlite sensors, but many are having trouble with the accuracy. I would not want to have the 679G monitor my BG and give me insulin, when I actually did not have a high that required any insulin. That could result in terrible hypoglycemia. Even the Dexcom CGM has occasional problems. I am using the Dexcom G4 and I do get false alarms a couple of times most days. I want to make my own decisions, I do not want a device doing that for me.

Wednesday, September 28, 2016

The Libre, Coming To The US

This is Abbott's FreeStyle Libre, a simplified CGM system that is not so expensive as the Dexcom. It has been approved by the FDA, and the consumer version should be available very soon now. It has been used in some other countries for several years. You can find the Libre users group on Facebook and ask questions there. This might be a good option for those of us who do not have insurance that will cover the more expensive CGM systems. It might also be affordable for out of pocket purchases.

Friday, September 23, 2016

Wednesday, September 21, 2016

FFL Conference, Summary

William Lee Dubois gives us a splendid summary of the Friends For Life Conference held in Orlando, July, 2016. It is well worth reading, even if you have attended the conference in the past. Wil is a gifted author, and has written some excellent books on Type 1 diabetes topics. I recommend that you read this article. Every reader will want to go to the FFL event in 2017. I was a speaker at the FFL in 2015, and I hope to do that again in 2017.

Wednesday, September 14, 2016

New Minimed 630g Pump

I am impressed by the new Minimed 630g insulin pump (see description below). So many great new features. I think I may switch to the Tandem tslim pump since it has a built in Dexcom CGM. I wear a Dexcom receiver while using my current Medtronic Revel pump. Now I have been told that the 630g will not be covered by Medicare since users will be required to use the CGM transmitter and sensors. I am very disappointed.

Monday, September 12, 2016

Diabetes and Skin Problems

Skin problems can be frequent with diabetes. I have very dry skin at times, and I use a moisturizing cream after bathing. Infections, and fungus are more likely for people with diabetes. The following quiz from has a lot of very useful information.

Monday, September 5, 2016

Diabetes Alert Dogs

I found this wonderful article on diabetes alert dogs (DADs). It is very well written, and can be an excellent guide to anyone who wants, or is curious about DADs. The author of this article is Dorrie Nuttall, one of my Facebook friends.

Wednesday, August 31, 2016

Judith Ball, 75 Year Medal

My friend, Judith Ball, writes about her trip to Boston, where she received her 75 year Joslin medal. The pictures show Judy's family, and friends who were there for the presentation at the Joslin Diabetes Center in Boston. Judy is my hero!! 
" I set a goal for myself and I met it! On August 12, 2016 in attendance with my husband, John, our two sons, John and Matthew, their wives, Evelyn and Helen, and our five grandchildren, Daniel, Michael, Margaret, Justin and James, I received the "JOSLIN VICTORY AWARD" medal for having lived with Type I diabetes for 75 years.
It has not been easy, for it is a frustrating disease to live with, and I have had the ups and downs that diabetics experience.
I am thankful to God, my parents and family, doctors, medical educators, and friends who have helped me to do this. I have been able to get a four year college degree, work in my field of study, marry and have healthy children, and continue to volunteer for several agencies.
I truly believe there are better days ahead for all diabetics who are willing to listen, learn, and do the best they can in controlling the disease. If today isn't a day of being in the good control range, then go to bed tonight thankful you made it, and when tomorrow comes, be thankful you have another day. Smile, it helps!
Thank you to Maya Khatri and Annie Lu for their assistance in my receiving the Joslin 75 Year Medal. My new goal is to get the Joslin 80 Year Medal in 5 years! Take care and enjoy the day."

Monday, August 29, 2016

Glucose Meter Accuracy

I am posting some older articles and blogs. I may eventually write new ones, but not for the time being.

Here is a great article by Riva Greenberg. Riva is a type 1 diabetic, and she writes articles for the Huffington Post. Her article concerns glucose meter accuracy, and other factors that influence our glucose control. The meter accuracy is important but accuracy in carb counting, and the levels of absorption of the insulin are also very important. In my case the insulin absorption is a major factor. After almost 62 years of injections, and 5 years of pumping, my body is riddled with spots of scar tissue. The level of absorption is very variable because of the scar tissue. I have to change programming on my pump every time I change infusion sets. When I change sets every 3 days I never know whether my absorption will be great, mediocre or poor. It was the same with injections. Some of my scar tissue is permanent. Be sure to rotate sites to avoid scar tissue. Here is Riva's article:

Friday, August 26, 2016

My Son Has Cancer

I have a son, 46 years old, in North Carolina. He was diagnosed with cancer in April. After five weeks of treatments his oncology doctor says he has at most two years of life remaining. My wife and I are devastated. I am not going to be posting blogs very often now. We will be making frequent visits to be with our son.

Saturday, August 13, 2016

Miss New Hampshire...Type 1...Vote

Miss New Hampshire Caroline Carter is type 1, and I am voting for her online. We can vote for her every day. With your help these votes can add up very fast.

Friday, August 12, 2016


I like Kerri Sparling very much. T1 for 25 years, and dx when she was 6. She started her blogsite several years ago. It is called "Six Until Me". It is a great site! The subject here involves T1D's who are misdiagnosed as T2. This blog was written in 2012, but incorrect diagnosing is still happening today. This happens very often when the dx occurs later in life. I have read about T1 being dx for people in their 80s. An organ can fail at any age, for so many reasons. So a pancreas can certainly fail in an older person. Why don't doctors realize this??? Here is Kerri's blog:

Wednesday, August 10, 2016

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.

Note: The definitions above were found on the CWD diabetes website. 

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 24 pounds. I initially used avandia for my IR, but started using metformin starting 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 29 pounds, and was then only four pounds above my ideal weight. Despite the weight loss, I still had IR. Metformin, eating an average of 140-160 carbs per day, and getting lots of exercise is now keeping me in good health. My A1c's are typically in the 5.8-6.1 range, 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.

Do you think you may have double diabetes? If you are type 1 and have gained weight, and are using more insulin than usual, then you might want to speak to your doctor (preferably an endo) about this.

Sunday, August 7, 2016

Insulin, When Not Eating

they should have given me some insulin even though I was not eating. (Today that would mean take your basal, but do not bolus, except to correct highs.) My blood sugar was sky high, but we did not know that since testing blood at home was not available until the 1980s. I was hospitalized for a week and put on a drip which included insulin. I still remember coming out of that so gradually and was so happy when I had enough strength to move my arms and legs again. I think I must have come close to death. Be sure you always take your basal insulin when you are not eating, and test so you can use bolus insulin to correct highs.

Wednesday, July 27, 2016

95 Years Ago Today

95 years ago today (July, 1921) doctors Banting and Best discovered insulin. What a marvelous discovery that was!!

Closed Loop Systems

There are several closed loop systems being developed. When they become available, we would have three options: insulin only to prevent high BG, glucagon only to prevent low blood sugar, and a combination of both (Bionic Pancreas aka the Islet). Human trials have been successful with several of the systems, and at least one of them is expected to have FDA premarket approval this summer.

Saturday, July 23, 2016

FDA Approves Dexcom for Bolusing

An FDA advisory panel approves using Dexcom numbers for blousing. It is hoped that this will lead to Medicare approval of Dexcom CGMs. Seniors need Medicare to cover expenses. I know I certainly do.

Friday, July 22, 2016

A New Product...Elovate

I have been trying a new product to help when I have low
blood sugar. It is called Elovate 15. A 6 packet box of cherry flavored powder, which dissolves very fast in your mouth. The pics below show how it helped me with a low of 57 on Tuesday. In 17 minutes My BG was raised to 74, and in another 17 minutes to 101. That is about the same as with glucose tabs, but I like Elovate much better. I do not like the hard crunchy texture and the aftertaste of glucose tabs. The taste of Elovate is great.

Thursday, July 21, 2016

Diabetes Innovator of the Year

Ed DamIano has a T1 son, and he has developed the iLet Bionic Pancreas. I heard Ed give a very wonderful and dynamic speech at the FFL conference in 2015. He was given a standing ovation , and it was well deserved!

Great Articles from DiaTribe

DiaTribe is one of my favorite sources of information on Diabetes topics. In my email today I have a link that explores the following topics: "People With Diabetes Are Not 'Suffering' and There is No 'Bad' Kind"; "Why Don't Some People Take Their Diabetes Medications?"; "What Are The Biggest Concerns in Diabetes?"; "Why is Access to Diabetes Education So Low?"
These and other topics are discussed in this issue from DiaTribe. You may want to subscribe and receive articles like these in your emails.

Saturday, July 16, 2016

Dr. Elliott Joslin

This is Dr. Elliott Joslin, a very famous doctor who diagnosed and treated diabetics many years ago. One of his publications involved Type 1 Diabetes, 1900-1950. The first 21 years of that time period was before insulin was discovered. The Joslin Diabetes Center, in Boston, was named after Dr. Joslin.

Tuesday, July 12, 2016

Time Out for Humor

I received this email today. I needed a good laugh!! LOL
"Growing up is a weird notion to wrap your mind around. As you go through life, your perspectives on almost everything will change. How you define success will change as well. Things that you thought were important at the age of 35 will be useless when you are 65. You may not realize it now, but everything will shift...
At age 4 success is not peeing in your pants.
At age 12 success is having friends.
At age 16 success is having a drivers license.
At age 20 success is having sex.
At age 35 success is having money.
At age 60 success is having money
At age 70 success is having sex.
At age 80 success is having a drivers license.
At age 85 success is having friends.
At age 90 success is not peeing in your pants.
It all comes full circle, whether you like it or not.
1960 Hits Renamed
Some of the artists of the 60's are revising their hits with new lyrics to accommodate aging baby boomers who can remember doing the "Limbo" as if it were yesterday.

They include :
Herman's Hermits ---
Mrs. Brown, You've Got a Lovely Walker
Ringo Starr ---
I Get By With A Little Help From Depends
The Bee Gees ---
How Can You Mend A Broken Hip?
Roberta Flack---
The First Time Ever I Forgot Your Face
Johnny Nash ---
I Can't See Clearly Now
Paul Simon---
Fifty Ways To Lose Your Liver
The Commodores ---
Once, Twice, Three Times To The Bathroom
Procol Harem---
A Whiter Shade Of Hair
Leo Sayer ---
You Make Me Feel Like Napping
The Temptations ---
Papa's Got A Kidney Stone
Denture Queen
Tony Orlando ---
Knock 3 Times On The Ceiling If You Hear Me Fall
Helen Reddy ---
I Am Woman; Hear Me Snore
Leslie Gore---
It's My Procedure, and I'll Cry If I Want To
And Last , but NOT least:
Willie Nelson ---
On the Commode Again
Every day may not be good. . ..
but there's something good in every day."

Sunday, July 10, 2016

Diabetes, Clinical Language Problem

The following blog was written by Sysy Morales, one of my favorite type 1 bloggers. She lives in Roanoke, VA. I was born and lived in Roanoke for 23 years. I have not visited Roanoke for six years, but I want to meet Sysy when I do. This blog is called "Diabetes and Clinical Language Problem: We Have the Power". It is very intelligent, and very well written.

Tuesday, July 5, 2016

Exiting The Diabetes Union

This is a wonderful article written by Riva Greenberg. Riva has been a T1D for 44 years. She has written three books about diabetes, and she writes articles in the Health section of the Huffington Post. I think you will like this!

Monday, July 4, 2016

Videos For T1Ds, 70 and 75 Years

Daniel Hargenrader makes wonderful videos. She interviewed me in 2015 and she interviewed Judith Ball this year. My interview occurred when I had been T1 for 70 years. Judith's video recognizes the completion of her 75'th year of T1D. The links for both videos are given below.

Sunday, June 26, 2016

Avoiding Complications

Avoiding Diabetes Complications
A few years ago the Diabetes Health magazine published an article stating that diabetics should maintain a good BG average and A1c, and avoid a roller coaster type of control. The roller coaster control involves having many highs and lows, and that would involve data widely scattered above and below the average. Blood sugars that rise and fall on the path of a roller coaster are traumatic to the body. Experiencing this trauma over and over again for a long period of time can lead to diabetes related complications, even if the A1c is good. I will demonstrate with two examples.
Patient A has test results 40, 55, 65, 100, 135, 145, and 160. The average is 100, but there are numbers that indicate unhealthy highs and lows.
Patient B has test results 72, 80, 94, 100, 106, 120 and 128. The average is again 100, but the data is more closely packed, and none of the numbers are undesirable.
Patient B is experiencing much better control, and is much less likely to have diabetes complications. The "standard deviation" (SD) is a measure indicating how closely the data is distributed above and below the blood sugar average. Patient A had much larger deviations from the average of 100. Patient B had smaller deviations, so the SD was much better. I try to keep my SD close to 20, but it is difficult to do. My A1c's have been in the 5.4-6.4 range for almost 10 years, but when I have too many highs and lows, my SD is higher and I can feel the neuropathy symptoms. I sometimes have some spots of retinopathy in both eyes if this situation persists for too long.
The purpose of this discussion is to demonstrate the fact that a very good blood sugar average can still involve diabetes complications if there is a significant number of highs and lows over a long period of time. Don't rely solely on a blood sugar average and A1c. Try your best to avoid so many highs and lows. A good average accompanied by a stable control is the best way to avoid complications. Proper dieting and well chosen exercise routines can help very much in avoiding the highs and lows.
I had A1c's no higher than 6.4 for almost 13 years, but had the beginning stages of neuropathy and retinopathy. My control had been tight, but it was necessary to make it even tighter. I stopped having so many highs and lows and after a few months had passed, the retinopathy disappeared. The neuropathy is still present in one foot, but I rarely experience any pain. If I have high blood sugar for several hours there is sometimes mild pain during the night. I have been a diabetic for 70 years, and have not had any serious complications. I want to keep it that way!!

Friday, June 24, 2016

Support From The DOC

Support From The DOC
My diabetes diagnosis was in 1945, a few days after my sixth birthday. There was very little known about diabetes back then. The only rule my parents had to follow was to not let me have sugar. I could eat anything else I wanted. There was very little change in my life except for avoiding sugar, and taking one shot of insulin each day. There was no device for testing my blood sugar, and no information about carbs, and their effect on blood sugar. It seems almost a miracle that I have now lived for 70 years with T1, and have no diabetes related complications except for some mild nerve damage. There are many other type 1 diabetics like me in the US who have lived with their diabetes for 50 years, or more. Many of them have received the 50 year medal from the Joslin Diabetes Center in Boston. A study is being done on the medalists to see if the factors can be found that have enabled them to live so long without any serious complications. I participated in the study in 2009.
Despite my having good diabetes health, there was so much I did not know about diabetes. My doctors in the early years knew very little about diabetes. In July, 2006, I watched an episode of the Dlife TV program. They mentioned that there was a Dlife website that offered support to diabetics. I joined that day. There were many diabetics of all types taking part in interesting discussions. There was so much information that was new to me, and it was easy to see this was the right place for me. How could I have gone 61 years without all the things I learned on the Dlife website? There were several other websites that were also very helpful, and I joined several of them. I shared my knowledge with my new online friends, and they shared their knowledge with me. Some of the members on Diabetes Daily convinced me to use an insulin pump. I started pumping in June, 2007. My blood sugar is much more stable now, and I have fewer highs and lows. I have not needed assistance with a hypoglycemic episode since July, 2007. I felt that the education I received from the diabetes online community (DOC) was so good for me. I helped many fellow diabetics on several diabetes websites, and that made me feel good.
I joined Facebook in December, 2010. There seemed to be an endless number of groups there that were focused on diabetes. I am currently a member of about 40 of those groups. I truly enjoy assisting the more uninformed diabetics, and their families. It is so easy to see how valuable it is to all participants in the online discussions. Many of them are getting too little advice from their doctors, but they receive many replies to their questions online. Hundreds of parents of young type 1 children were impressed by my longevity and good health. They tell me that I have given them inspiration and hope for the futures of their children. My wife and I attended the Friends For Life (FFL) type 1 conference in Orlando, FL, in 2015.It is an international conference for type 1 diabetics, but the emphasis is on the type 1 children and their families. There I was able to meet many of my online friends. I was a speaker that year, and I enjoyed speaking to my audience.
My communication with my online friends, and the research I have done, has given me experience and much knowledge about type 1 diabetes. I have written a book about my life with diabetes, and have given talks to two local diabetes support groups in my part of New York. It would be great if I had the opportunity to become a motivational speaker, and visit many areas in the US.
It is a dream of millions of diabetics to have long, healthy, and productive lives. The DOC provides the support, education, and incentive to make this possible.

Friday, June 17, 2016

Long Term Success With Type 1 Diabetes

I have been type 1 for 70 years, and I do not have any serious diabetes related complications. While participating in the Joslin medalist type 1 study in Boston, I was told that several participants freely admitted that they have not taken good care of themselves. They eat a lot of food containing sugar, and other fast acting carbs. Despite their bad eating habits, they do not have any complications after many years of type 1. All of the 1000+ participants have been type 1 for at least 50 years, and are US citizens. I was also told by the lady in charge during my participation that several participants have used tight control, but have experienced some serious complications. These are the exceptions to the rule. The majority of the participants in this study have done at least reasonably well with their control, and they do not have any serious complications.
In the Joslin Medalist Study, Dr. George King, head of the study, did discuss the "special inner protection" that so many medalists have. He said that this mysterious protection seems to protect us against serious problems with our eyes, kidneys, and our nervous systems,,,,but not our hearts. He wanted us to know that we should take every precaution to keep our hearts healthy. There is a secret group on Facebook called "The Joslin Medalists" where many members have posted about their stents, bypass surgeries, heart attacks, etc...but these same people have good eyesight and healthy kidneys.
After almost 60 years of type 1, I was diagnosed with spots of retinopathy, and neuropathy. My A1c had been in the range 5.4-6.0 for many years, but I still had these complications. My control involved too many highs and lows, a roller coaster type of control. Those highs and lows can produce an average which is quite good, so the A1c will also be good. That can give us a sense of false security. The roller coaster control is traumatic to our bodies, and complications can result, even though the A1c is good. I started pumping insulin in 2007, and my control was much more stable, with not so many highs and lows. The retinopathy disappeared, and has been gone for nine years. The neuropathy is still present, but it rarely bothers me now. Avoiding complications seems to require a good A1c, and more stability with not so many highs and lows. If I had started pumping in the 1990's I may not have had any complications at all.
I read an article a few years ago that said the life expectancy of young type 1 diabetics in the US is almost as good as for non diabetics. That is very encouraging news!!

Monday, June 13, 2016

An Endo, T1 For 80 Years

I have been type 1 for 70 years, but there are people who have been type 1 much longer than me. Here is an endocrinologist with type 1 for 80 years. A wonderful story!!

"Last month, Joslin awarded Dr. C Kenneth Gorman the Lifetime Achievement Award for living for 80 years with type 1. Dr. Gorman is one of five recipients of the 80-year medal and the only Canadian recipient thus far. In 1935, at the age of two, Dr. Gorman was diagnosed with T1D. He went on to become an endocrinologist and worked as a research fellow under Dr. Charles Best, one of the co-discovers of insulin. During his time with Dr. Best, Dr. Gorman began corresponding with Dr. Elliott Joslin and accepted a position as an N.I.H. Trainee Fellow in Diabetes at the Joslin Clinic from 1962 to 1964. Dr. Gorman's next goal is to celebrate the 100th anniversary of the discovery of Insulin in 2021. Congratulations, Dr. Gorman!

For more information on Joslin's medalist program or to apply, click here:"

Saturday, June 11, 2016

Type 1, Not Autoimmune?

I have always assumed that all T1 diabetics are autoimmune, but is that necessarily true? Have any of you diagnosed with T1 been given the GAD65 test for autoimmunity? I have not had that test done. My diabetes was diagnosed when I was recovering from chickenpox and mumps when I was 6 years old. Those diseases probably caused internal damage to my pancreas. If physical damage causes a pancreas to stop producing insulin, then why would that necessarily mean autoimmunity is present? I do not have any relatives who are/were T1, so I feel my T1 is not genetically induced. I think it is possible that I am T1, but not autoimmune. Do any of you think this is possible?
I have an endo appointment soon, and I am going to ask for a GAD65 test. I hope she will agree to my having the test.
Here is the link to the GAD65 test:

Thursday, June 9, 2016

Diabetes Burnout

There are many articles, blogs and books about diabetes burnout. It is being discussed in the Joslin Medalists Facebook group. Like some of the other medalists, I do not feel that I have experienced burnout. I was diagnosed in 1945, when I was only 6, and diabetes became my way of life. I do not remember any other way of life, and I am comfortable with living with diabetes.
The article below says that diabetes burnout does exist, and it is different for everyone. Do you, or have you experienced diabetes burnout? If so, how do you describe your burnout? What are the symptoms you have experienced? How do you cope with it?

Diabetes Advocacy

I enjoy being a Diabetes Advocate. The link below gives you the opportunity to sign up to join our team of advocates for diabetes. "Your advocacy experience, your story, makes you an effective recruiter to build our momentum for more wins that lead to better care, fair treatment, and, ultimately, a cure for diabetes."

Wednesday, June 8, 2016

My Podcast Interview

Stacey Simms has a podcast network called Diabetes-Connections. On Sept 1, 2015, she interviewed me in a podcast shown below.

If you want to listen to more of Stacey's podcast interviews, use the link below.

Wednesday, June 1, 2016

Puming Insulin in 1978

The following blog was written by a lady in Australia who started
using an insulin pump in 1978. She gave me permission to post this blog here.

(Written in 2003)
I was thinking at some ungodly hour last night how much I love the current pumps, and how different they are from 25 yrs ago, and thought I'd actually specify what pumping in 1978 involved.

First off, there were no easy plastic cannulas you inserted at home. Initially, the cannulas were similar to IV drip cannulas, and yes, they hurt. Mine were inserted into my butt... but not just put in and left, no no. The whole procedure was done at the hospital and involved betadine swabbing, a local anaesthetic, at least two medical staff, the whole shebang/catastrophe. After the site was swabbed thoroughly and the local given (why do locals sting so much??), the doctor (usually an endocrinological registrar; if you were unlucky, a resident) would thread the cannula in, using a rather large introducing needle (21g I think), then back OUT, and in again. I have no idea why this was necessary, but at the time it was deemed to be so. If these sites had problems - infections - they exploded along the whole line. I had one infection so severe that 25years later I still have a small crater on my right buttock from it being excised and drained (but thankfully can no longer remember the intense pain associated with the three direct penicillin injections straight into the site that were administered). Sites were usually replaced every 5 days, and I dreaded those days. The whole procedure took about 3hours.

As a back up, we had "butterflies" (winged infusion sets). If a cannula came out, a butterfly could be used as a stopgap until a new cannula could be inserted. Butterflies brought their own horrors, of course. While they had a much finer gauge (as small as 25G at one stage, more commonly 23G) and were far shorter, positioning them was very difficult because they were inflexible metal needles. Regardless, the trauma of the cannula insertions led me after 3mths to request the use of butterflies on a permanent basis (at the ripe old age of 13!).

Now, one problem with the butterflies was that the tubing actually absorbed insulin, so priming them was a time consuming business. First, insulin for the "day strength" syringe (presuming it was day time) had to be prepared (I generally prepared 6 days' worth of day and night syringes in advance, and labelled them so I could tell them apart, storing them in the fridge). Preparing a syringe was fiddly/fussy, but not difficult. It meant getting a 2ml syringe (or more, depending how many were being prepared), using an insulin syringe to withdraw the correct amount of insulin for the particular syringe, injecting it from the drawing up (insulin) syringe to the "pump" (2ml) syringe, then using a second 2ml syringe to add normal saline to the pump syringe to dilute the insulin adequately. The fully prepared syringe - with insulin and saline in proper proportions - could then be capped with a sterile needle and stored in the fridge. Day and night strength syringes were quite different, and varied over time. To actually prepare the butterfly meant taking the pre-prepared syringe, and rinsing the tubing of the butterfly out TWICE, before gearing it up for insertion (we also did that with the 2ml syringes, adding a small amount of insulin and flushing it through the syringe twice).

Using butterflies was "interesting". When I first started putting them in, an insertion, including swab padding and taping took me about 15 minutes. After some years I had it down to 2.5 minutes (yes, I timed it, I was a busy girl!!). Using both cannulas and butterflies meant you could only sleep on 3 of your possible 4 sides (front, back, left and right), as you invariably had a sore spot or a potentially sore spot on the fourth. If you bumped a butterfly it was wont to dislodge, which was not only extremely painful but meant, of course, that your insulin delivery was disturbed or possibly discontinued. I look back on all of this and wonder how I endured 17years of it really - but endure it I did, and gladly. Finally I was able to eat what I wanted when I wanted and I was no longer left out of more "normal" activities that had previously been denied me because of my diabetes.

Placing a butterfly involved having the following things on hand: butterfly, syringe, pump, gauze pads, tape, and alcohol swab. First, the site had to be swabbed (in later years I left this part out, as well as the priming of the tubing). The butterfly was "fed" with insulin (no checking for air bubbles back then). Then, the needle would be inserted, at anywhere from 40-70degrees. Gauze placed under the wings of the butterfly helped to prevent it pressing down and thus the actual needle pushing up through the subcutaneous tissue (ouchy!), meaning it stayed relatively stable; a piece of gauze over the wings meant that the entire dressing could be replaced at any time without (theoretically) displacing the needle. Lastly, tape would be applied liberally to strap it all down, and the syringe and pump would be reconnected.

The first pump, of course, was somewhat of an encumbrance. It was a Millhill infuser, and it was all metal. Hence, every time I flew to Sydney (my family and I were living in Canberra) it would set off the metal detector. Canberra airport in the mid to late 70s was a quiet place, however, and they came to expect me every 3mths, jetting off to Sydney for my 48hour line to be put in, where blood was taken every 30minutes night and day to try and get a profile of what my blood sugars were doing. It was all very false of course, but all they could get, since I refused to do even rudimentary tests at home (when they became available). The Millhill was about 20cm (8") long, 10cm (4") wide and 5cm (1.5") deep. It was LARGE. It was later replaced by the Graseby Infuser, which was slimmer, but still large. Both were kept (by me) in a specailly made pouch that was worn on my thigh, with straps that went up around my neck (sans boobs) and my waist (apres boobs), with an additional - optional - strap around my thigh to ensure it didn't bounce around.

The pumps did not have variable basal rates. You had a set rate and that was it - but at least it meant you were getting a steady stream of insulin 24hrs/day (all being well). The number of times I disconnected and then lost my needle, dressing and all, in the surf is uncountable. I hate to think what the finders thought of their strange flotsam and jetsam. Bolusing was also an interesting event. In theory, you could program the pump to push through X mm (yes, millimetres, on a scale, which had to be converted depending on the size of the syringe - 2ml was my standard but these pumps could take 5 and 10ml syringes as well - to ml, which then had to take account of how much insulin - diluted, remember - was in each ml) at a particular time. It was very difficult, so much so that I took to just going "OK, here's my syringe, I know it has about 0.7units per .1ml, so I need half a little mark" and manually pushing that through. If you didn't know how to carb count, you were completely lost - and even some of us who knew how to do that - in "portions" - were still lost.

It's funny, I've just written all this and it sounds archaic and nightmarish now .. but at the time it was cutting edge and it saved my life. I still have my old pump and pouch. I wonder if I'll ever discard them? Somehow, I doubt it.