Wednesday, May 24, 2017

My Early Life, Without Sugar


When I was diagnosed in 1945, the doctor told my parents that I should not eat anything containing sugar. I don't remember my reaction to being denied sugar at that time. My diagnosis was only a few days after my sixth birthday. I do remember missing sweet things to drink. For some time I drank milk from our own cows. That was not a good choice, but we did not know that. It did not contain sugar, so we thought it was ok. When we went grocery shopping my family did not buy candy, cookies or ice cream. I don't know what my sister thought about that, she was three years younger, and she probably wanted sugary treats.
A year or so later, we discovered saccharin at a drugstore. My mother learned to prepare desserts sweetened with saccharin. I had pies, cookies, and a birthday cake sweetened with that wonderful stuff. Saccharin was great! Mother made desserts sweetened with sugar for the rest of the family. I was happy with my own desserts, and I never wanted to taste of theirs. My father prepared homemade ice cream, and a portion sweetened with saccharin was set aside for me. I always looked forward to that. It was a summer treat.
One day in our grocery store we saw a display of little bottles containing colored liquids. It was called Kool Aid. It was invented in the 1920s and initially sold in concentrated liquid form. Later on it was sold as a powder in little packets. The Kool Aid we bought in the 1940s was in a concentrated liquid form, so we added water and saccharin. It made a delicious drink. I was very happy.
I had low blood sugar at times for many years, and my mother gave me a glass with some water mixed with sugar. That was the only sugar I had for very many years. I had some awful seizures at night several times each year, and the sugar water was ready for those occasions. If I could not drink the liquid, my father would sit behind me on my bed and prop me up while my mother rubbed the sugar water on my lips and gums until I had enough to bring me around, so I could drink some of the liquid. I think I may have associated the sugar with my seizures, and that may have made sugar even more undesirable.
There were no meters for measuring blood sugar for my first 40 years after diagnosis, so my urine was tested for sugar each morning to determine my insulin dosage, and then I had to depend on my own feelings to detect low blood sugar the rest of the day. While sleeping at night my parents would listen for me to be thrashing around in bed to determine that I had low blood sugar. Their bed was close to mine for many years, so that worked out well.
Now I will fast forward to the current century, and tell you about a discussion that my sister and I had a few years ago. Our father worked at a post office, and he had an afternoon and evening shift. He got home at 11:30 PM. She told me that he would stop at a store on the way home from work and buy candy bars. They were hidden high in a cabinet in the kitchen. I can remember entering the kitchen several times and my sister was standing with her back against a wall, with her hands behind her. I guess I was not curious about that. She was hiding a candy bar she had been eating. I never saw a candy bar, and she waited more than sixty years to tell me about that. We laugh a lot about her candy bars. I am glad she had them, and I am glad I did not see them. 

Tuesday, May 23, 2017

Positive Effects Of Diabetes

Another wonderful and inspiring article from Brittany Gilleland and The Diabetic Journey. I love the article, and the picture. Thanks, Brittany!!



Thursday, May 11, 2017

C-peptide...Part 2

C-peptide .....Part 2

In the 1970s a study seemed to show that C-peptide was of no practical value in preventing diabetes complications, but "...the possibility that C-peptide may exert direct effects of its own was reevaluated in the early 1990s. A series of studies was undertaken involving administration of the peptide to patients with type 1 diabetes, who lack C-peptide. This approach gave positive results, and it became apparent that replacement of C-peptide in physiological concentrations results in significant improvements in several diabetes-induced functional abnormalities. These surprising findings prompted a renewed interest in C-peptide physiology, and during the following 15 years, a steadily increasing number of reports on new aspects of C-peptide physiology emerged. The information available included studies of the peptide’s interaction with cell membranes and its intracellular signaling properties. In vivo studies in animal models of type 1 diabetes have defined a beneficial influence of C-peptide on diabetes-induced functional and structural abnormalities of the kidney, peripheral nerves, and central nervous system. In addition, several studies in type 1 diabetic patients describing positive effects of C-peptide replacement therapy on nerve and kidney function have appeared. The wealth of information now available supports the notion that C-peptide administration, together with regular insulin therapy, may be beneficial in the prevention and treatment of microvascular complications."

Here is the link with a more thorough presentation of that research:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3314360/

There have been many online discussions concerning C-peptide, and its being potentially helpful to people with type 1 diabetes.The following are examples of those discussions.

Here is a link giving a good discussion about C-peptide on diabetesdaily.com. I have been an active member there since 2007. (I don't know if you can view this discussion unless you are a member of Diabetes Daily.)

https://www.diabetesdaily.com/forum/diabetes-news-and-studies/79493-low-c-peptide-bad-type-1-a-2

There was an attempt by a company called Cebix to produce an injectable form of C-peptide. The project failed during human trials. Here is some of the background of that project.

http://www.xconomy.com/san-diego/2015/02/23/cebix-shuts-down-following-mid-stage-trial-of-c-peptide-drug/#

In another online diabetes support group, one person posted that Lilly had experimented in including C-peptide in the human insulin they had been producing. I do not have any details on this, and have not been able to find any information by researching online. If anyone finds any information about that, please let me know. Lilly aborted the experiment, so I am told.

Another discussion was made that suggested that having C-peptide in the synthetic insulin that we use today could cause major problems. People with type 2 still produce a significant amount of their own insulin. That insulin contains C-peptide. If type 2 individuals then injected insulin with C-peptide, there might be an overdose of it. Too much C-peptide is known to be harmful. Only type 1 people should use an insulin containing C-peptide. Some T1D's still produce some insulin for a period of time after diagnosis. That happens during the 'honeymoon' period with many individuals. Even some Joslin Medalists, T1 for 50+ years, have been found to still produce some insulin. So, there are both T1 and T2 individuals for whom insulin containing C-peptide could prove harmful. Maybe that is the reason any experimentation involving adding C-peptide to insulin was considered inappropriate. I am just guessing, but all of this does make sense to me.

There does not seem to be any present day attempts being made to add C-peptide to insulin, and the attempt to produce an injectable form of C-peptide has failed, for reasons stated. I am not aware that any other attempts are being made to provide us with C-peptide, but I have not given up hope. I am thinking that each individual could be tested and the appropriate amount of C-peptide needed could be determined. Then a prescription could be given that would enable that individual to inject that amount of C-peptide daily, weekly, or for an appropriate time schedule. That may seem far fetched, but I think there has to be a way for us to receive some of this potentially valuable substance.

What are your thoughts?

Tuesday, May 9, 2017

C-peptide...Part 1

C-peptide....Part 1
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. Microvascular complications pertain to the smaller blood vessels and include retinopathy, neuropathy and kidney failure.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
I used animal insulin for 50 years, and it contained C-peptide, which helps protect us from many diabetes related complications. That may help explain why I, and so many other long term type 1 diabetics, did not have those complications back then. In the 1990s I started using synthetic insulins, which did not contain C-peptide. By the end of that decade I started having some complications. Was that a coincidence? I don't think so.
 I was diagnosed with spots of retinopathy in both eyes, and neuropathy in my feet. I started using a pump and my control was more stable. The retinopathy disappeared, and has not returned, but the peripheral neuropathy is now in my feet, legs, hands and arms. There is not enough pain to require medication at this stage. I also have autonomic neuropathy in the trunk of my body. None of my neuropathy is severe, but it is very annoying.
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.
"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)"
In the early stages of the Joslin Medalist Study 725+ participants 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 were still producing some of their own insulin. My C-peptide level was less than 0.1, showing that my good health after 71 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 appear.
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."
I have believed for many 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 so many of the Joslin Medalists. Today's synthetic insulins do not contain any C-peptide. 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 so many of the medalists. Maybe he will have changed his mind when the study concludes.
The links below are my references. They discuss C-peptide in much more detail.
Note: In a few more days I will post Part 2 of this discussion: An online discussion in the Diabetes Daily group; An attempt to produce an injectable form of C-peptide; Adding C-peptide to synthetic insulin.

Saturday, May 6, 2017

Artificial Sweeteners


I was diagnosed in 1945, when I was 6. I think saccharin was the only artificial sweetener back then. I used saccharin throughout my childhood, and many years beyond. Then there was Sucaryl, a liquid sweetener that contained cyclamate. The cyclamate was found to cause cancer, so it was no longer sold. There were several other artificial sweeteners after that, none of which I used. I was still using saccharin. Then a Canadian study reported that saccharin caused cancer in rats. It was banned in Canada, the UK, and some other European countries. I could not find it at my grocery store or drug store. A report emerged that said the statisticians in the Canadian report had fed the rats very large amounts of saccharin. If a human ate an equivalent amount of saccharin, proportional to weight and body size, it would probably cause cancer in humans, too. That was false and misleading statistical research. Saccharin was no longer banned in the US, but it was still banned in Canada. I use Sweet 'n Low, in the little pink packets. If you read the label you will see that product contains saccharin. I was so accustomed to saccharin for such a long time that Sweet 'n Low seems just right to me. I have used it for a long time. I think there were other sweeteners that were reported to cause cancer. Do you see a pattern here? If one sweetener is found to cause cancer, probably in rats, and it is banned, then the coast is clear for introducing a new sweetener. But, does the one that was banned really cause cancer , or was it a scam caused by false reporting, like the one with saccharin?
Aspartame is in all the Crystal Lite and the diet sodas that I drink every day, and it has been reported to cause problems with some users, but I don't think it has been reported to cause cancer, yet.
For 71 years I have been a type 1 diabetic, and I have used artificial sweeteners for all of those years. I feel perfectly safe with all the sweeteners I have used.
It has been reported that diet sodas may cause "dementia and stroke", really? If we could see the statistician's report, we might find some inappropriate sampling techniques. I am not going to stop drinking a quart of Crystal Lite, and a diet soda each day. I am not going to stop using an average of three packets of Sweet 'n Low each day. I feel perfectly safe with these artificial sweeteners.

P.S. Have you looked up some of these topics on the "Snopes" website? You can find some very interesting reports there.

http://www.healthguidance.org/entry/9882/1/Is-There-a-Safe-Sweetener.html

Saccharin history:
https://saccharin.org/history/

Thursday, May 4, 2017

Joslin Medals Update

  1. Joslin Medals for Long Term T1D
  2. On February 26, 2017 there were 5,123 people who had received the 50 year Joslin medal. There were also 95 who had the 75 year medal, and 9 had the 80 year medal. The number of people living with T1D for 50+ years is growing by leaps and bounds. People from all parts of the world can apply for the Joslin medals, but some proof is required to verify the numb...er of years with T1D. There are many T1D's who do not know about the program. If you know someone who has been type 1 for 50 years, please tell them about the medals. Tell them they can join the secret Facebook medalist group and talk to so many others with type 1 for 50+ years. They can also attend meetings of the medalists in odd numbered years in Boston. Joslin has a very good program for the medalists who attend. Here is a link for applying for the medals. You can also apply for a 25 year certificate.




Thursday, April 27, 2017

Man Makes Insulin During War Time

Man Makes Insulin For His Wife

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, Eva Saxl, and many other people alive, during war time. She gave lectures, and helped others. She passed in 2002.


Saturday, April 22, 2017

The Artificial Pancreas Scares Me

After 40 years of testing urine, and not really knowing my blood sugar levels, it was wonderful to have my first glucometer in the mid 1980's. My control was really bad those first 40 years. After using a meter it was obvious that my BG had been much too high during those years. I was seeing numbers in the 200's very frequently, and numbers in the low 300's, too. I felt comfortable at those levels, but I felt uncomfortable below 150, and hypo below 120. It took a lot of adjustments with my diet and insulin dosages to feel good while having numbers in the low 100's. Control was better, but still not so good, until synthetic insulin was available in the 1990's. By the end of the 1990's I was able to use carb counting, and a fast acting insulin. Then my numbers  were so much better, and my A1c's were in the high 5's. I do not know how I survived for 50 years on animal insulin, and type 1, without having any serious diabetes complications. 

Improvements in the 21'st century are happening so fast, perhaps too fast. There are several artificial pancreas devices being developed, and tested on human subjects. They depend on a CGM for measuring the blood glucose levels. I am using a Dexcom G4, and it is very accurate about 80% of the time, but there are times it is as much as 30 or 40 points different from my meter. If I was using an artificial pancreas device, and I had a false high, I could be given insulin that I did not need. That would give me a hypo, maybe one that would put me in the hospital! There are devices being developed that would give us insulin when we are too high, and glucagon when we are too low. We would not be making the decisions. The device would be making the decisions for us. I feel very uncomfortable with that. The almighty CGM is not accurate enough to have the device do the decision making. I know that the Dexcom G6 is being developed, and it will be more accurate, but I cannot believe that the accuracy will be good enough that we would never have occasional false highs and lows with that CGM. For that reason I will not use an artificial pancreas, even if one was given to me as a gift.

The "Guardian® sensor 3 continuous glucose monitoring sensor Introducing the most accurate sensor from Medtronic, now with up to 7 day wear and easy insertion. It is the FIRST and ONLY continuous glucose monitoring sensor FDA approved and trusted to control insulin dosing." That one is being sold now, but I will not use it. I am chicken! I am eligible for a new pump in May, but I will be getting the Medtronic 630g. That one can be used without the CGM supplement. I will be wearing my Dexcom G4 CGM, and I will be making all of my own decisions!! I have made my own decisions for 71 years, and I have done very well. I want it to stay that way for the rest of my life. :)

Wednesday, April 12, 2017

Diabetic Seizures

Throughout my early years as a diabetic I had no major health problems, and I coasted along rather easily. I was always very skinny, maybe slightly underweight, until many years later. I had high urine sugar during the day, and usually at night. There were, however, some nights that I had very bad hypos. My bedroom door was always left open at night, and my room was immediately across the hall from my parent's room. Mother was keyed in to my thrashing about, and the moans I would make when having a hypo. She would jump out of bed, and grab a glass containing several tablespoons of sugar. She stopped at the bathroom, partially filled the glass with water, stirred the mixture with a spoon, and entered my room. Daddy raised my body, sat on the bed behind me, and held me while Mother slowly poured bits of the sugar water into my mouth. This usually worked very well, but occasionally my mouth was shut so tightly that she could not get any of the liquid into my mouth. Some of these hypos were very bad, and they became seizures. It took a long time to get me to the stage that they could get me to drink some of the sugar water. She would rub some of the liquid on my lips, and I would lick my lips. This gave me just enough sugar so I would start to relax, and then she could get me to swallow some of the sugar water. I would come out of these seizures not remembering any part of what had happened. I would clinch my muscles while having a seizure, and there was much soreness for days afterwards. I ground my teeth together, and there was damage to those teeth that is still present today. I have read that some people have bitten off parts of their tongues during a seizure. I am glad that never happened to me. I was always so grateful that my parents took such good care of me at those times. Our family home back then was north of the city of Roanoke, Va. The nearest hospital was far away. An ambulance would have taken a very long time to reach us. That is why my parents needed to handle my seizures without additional help.
I have no idea how many of these seizures I had before I was an adult, but I know there were many of them. I attended local colleges, and lived at home during those years. I did not leave home until I was 23. My first full time job was teaching math at a college three hours from my home. I met a young lady named Anita there. She was a sophomore. Teachers were permitted to date students at that college back then. We dated during my first year of teaching. We were married in 1964 after only seven months of dating. Maybe that was too hasty, but it has worked perfectly. We have had a wonderful marriage for 52 years now. I had a few seizures after we were married. Maybe two per year. They were not as frequent as they were when I was still living at home. Mother had instructed Anita on how to care for me during a seizure. Anita handled my seizures perfectly. She remained calm, and used the sugar water treatment just like mother had done. I think it was in the mid 1980's that I had my last seizure. There was one that was very bad, and I was hospitalized. Anita had not been able to bring me out if that one. That was the only time that I was hospitalized with low blood sugar.
In 1980 I had my first A1c testing, and in the middle of that decade I had my first meter, Finally, I could measure my blood sugar at home. I learned about carbs and there effect on blood sugar, and my diabetes management improved. My seizures occurred during my first 40 years after diagnosis, before all this new knowledge, and having a meter. If we had a meter for testing, basal and bolus insulins, and carb counting during my earlier years, things would have been very different. There would have been less serious hypos, without the terrible lows that caused seizures.
I know that some of my Facebook friends have had seizures soon after diagnosis, while learning how to care for themselves. I have read about children having seizures, and their parents giving them the needed care. This results in trips to the ER on many occasions. I have joined several parents groups, and have read about the problems that occur with child care, with diabetes. I have been welcomed to those groups since I was diagnosed when I was 6, and have lived with type 1 for 71 years without any serious diabetes complications. When parents hear about my past, they realize how much better things are now. That gives them some calm, and peace of mind. It is still very difficult to manage a child's diabetes, especially soon after diagnosis. I am glad there is so much knowledge today, knowledge that was not available in the past. That knowledge, and the devices that are now available, makes diabetes management so much better.
There has been some speculation that seizures can cause brain damage. I have not had that problem. I had a college education, and became a math professor at the college level. I do not think seizures would cause brain damage, unless they were very severe. A seizure that resulted in a coma might cause brain damage.
Glucagon injections can be given at home in modern times. That is the best way to handle a seizure. You can get a prescription from your doctor for glucagon. This assumes that the seizures are due to diabetes, and very low blood sugar levels. Seizures can also be caused by other conditions such as epilepsy.
The following links give very good information about seizures. There are replies from some people at the end of the first link describing seizures that they have had. Interesting discussions.

Monday, April 10, 2017

My Diabetes Now vs My Early Years

From the year of my diagnosis in 1945, until the mid 1990s, I did not need any medications, and there were no diabetes related complications. That was approximately 50 years with no problems. How was that possible? Beef and pork insulins did very well for me, although common sense suggests my blood sugar must have been very high most of the time. The urine tests every morning showed very high urine sugar on most days. There was only one urine test each day until Tes-tape for easier urine testing was introduced a few decades after my diagnosis. There was no basal and bolus control, and no involvement of carbs in my daily routine. My meals consisted of hundreds of carbs, and there was no information about my needing to limit my intake of any foods, except those containing sugar. My doctors had very little advice for me. Despite all these factors, there were no diabetes problems. There may have been DKA on some occasions, but I did not know about DKA until the present century. So how did I avoid complications for such a long time? I think it may have had something to do with the beef and pork insulins I used for all those years. Several online long term friends agree that the insulin we were using did seem to offer us protection from the complications to our eyes, kidneys and our nervous systems. Maybe it was the C-peptide in the animal insulin. C-peptide is known to offer protection against diabetes complications. The synthetic insulin we use now does not contain C-peptide.
When I started using synthetic insulins in the mid 1990s, things were so different. I was aware of the involvement of carbs at that time, so my eating habits had changed. My carb intake was greatly reduced, and foods with fast acting carbs were restricted to smaller portions. I counted carbs and determined appropriate insulin:carb ratios. That, along with my basal and bolus insulins, resulted in my having A1c's below 6.0 soon after the start of the new century. My A1c's before the mid 1990s were much much higher. I think my highest many years ago was 13.
In the late 1990s I needed medications for cholesterol, blood pressure, and water retention. I was also diagnosed with carpal tunnel, and ulnar nerve problems. Frozen shoulders, and cataracts occurred during that time. I was also diagnosed with neuropathy in my feet, and spots of neuropathy in my eyes. All of those things occurred after I stopped the animal insulin, and started using synthetic insulin. How can this be? We know so much more about diabetes now, and we have devices, basal and bolus insulins, and medications that can improve our control so much. Indeed, my control did improve very much, but those complications and the need for medications did occur. Don't you think it would have made more sense for me to have complications in my early years, when I had so much high blood sugar, and almost none of the present day knowledge? I am certainly not unique. There are a few thousand type 1 diabetics in the US who have lived with diabetes for at least 50 years, and without any serious complications. More than 6000 have received the Joslin 50 year medal. Some of them have been type 1 diabetics for 10 or more years longer than me.
There is a study taking place at the Joslin Diabetes Center, in Boston. It began in 2005, and was to have been a ten year study, but it is ongoing at the present time, in its thirteenth year. I participated in the study in 2009. The purpose of the study is to determine the factors that have enabled so many long term type 1 diabetics to live so long, and be so healthy. Maybe the reason so many of us had no complications during our early years will be revealed.
My having some mild complications in the 1990s, and not earlier, is still a mystery to me. Now, in the year 2017, I have more neuropathy problems, but the retinopathy is gone due to better control with my insulin pump. My neurologist gave me an EMG test in January, 2016. He says I have severe polyneuropathy in my legs. There is no bad pain, just numbness, and I do not need medication, so I'm not sure it is severe. Some mild arthritis, some dizziness in the mornings, and the neuropathy are all that are present now. The dizziness and neuropathy make me wobble a bit when I walk, somewhat like a duck. Maybe I can get a job working on TV for Affleck? lol
I am so fortunate to be doing so well, but I will always be curious about how it has all evolved.

Friday, April 7, 2017

William Rounds, Type 1 for 87 years

William Rounds (1922-2010) was diagnosed with diabetes in 1923, only 2 years after insulin was discovered. He was T1 for 87 years the year he died. In 2008 William was one of eleven interviewed who had lived for 60+ years with T1D. I was one of the eleven. The stories were published in Oct, 2008 in the Diabetes Forecast, the American Diabetes Association's magazine. That was the month that the Diabetes Forecast celebrated its 60'th anniversary.


http://www.diabetesforecast.org/2008/oct/long-lives-lived-well.html

Wednesday, April 5, 2017

My First 64 Years With Type 1

My book was published in March, 2010. It is an autobiography of my first 64 years with type 1 diabetes. It begins in September, 1945, the month I was diagnosed. The book is available on Amazon.

Thursday, March 30, 2017

Special Video, Boy With Type 1

This is a terrific video about a boy named Luke, who was diagnosed with type 1 diabetes. I hope that you will watch the video.

Monday, March 27, 2017

Isolated With Type 1?

Did you ever feel isolated as a type 1 diabetic? I did for more than 60 years until I discovered the diabetes online community (DOC). Most of what I know about type 1 was learned online. It is wonderful to be able to communicate with other diabetics. The picture below depicts my place in the world of diabetes before I discovered the DOC.


Thursday, March 23, 2017

Diabetes Mine, My 70 Years With T1

Here is the introduction on the Diabetes Mine page. It is one of the very best sources on diabetes reporting.
"We offer a unique mix of news, views, reviews, guest posts, interviews, videos, cartoons, Q&A and any other type of quality content useful for people touched by diabetes.
We provide a strong voice of patient/consumer advocacy for the diabetes community.
We aim to improve life with diabetes by acting as a catalyst for innovation."
Amy Tenderich, Michael Hoskins and William Lee Dubois are the hosts on Diabetes Mine. They write wonderful blogs.
In July, 2015 Michael asked me to write a blog about my diabetes history. Michael did a wonderful job editing and presenting that blog. Here is the result:



Thursday, March 16, 2017

Tuesday, March 14, 2017

Four Brothers, Three are Type 1


Meri Schuhmacher-Jackson has four sons, and three of them are type 1. She has a super blog site called "Our Diabetic Life". Here is a sample of her writing. Great stuff!!
http://www.ourdiabeticlife.com/2017/03/the-avalanche.html

Monday, March 13, 2017

Feeling Guilty About Feeling Guilty

I was a member of the diabetes support group at diabetesforums.com (not on Facebook) a few years ago. Here is a blog I presented there in 2013. The link below shows the discussion with 19 replies made that year. (I'm not sure you can tap into that link if you are not a member there. Let me know if you can.)
For many years now I have been thinking about the past and the fact I knew so little about my T1 diabetes. My doctors did not know much either. There were no T1Ds that I knew back then, in fact there were no types when I was diagnosed in 1945. Types were identified years later. I lived in a rural area in south central Virginia for my first 23 years. Given those circumstances, maybe I should not feel guilty about my ignorance, however, I now realize that there were parts of the country where many newly diagnosed diabetics had very good doctors who knew so much about diabetes. I have seen many fellow medalists post that they were patients of Dr Joslin in the Boston area. Dr Joslin specialized in T1, and he even wrote a book about T1 in the years 1900-1950. That book can still be read online...very interesting. If I had read that book in my younger years, I would have had much more stable control. Some medalists have written about knowing about carbs, and weighing their food. I never heard about carbs and their effect on T1 control until the late 1980s.
Many days I feel guilty that I knew so little for so many years. Why? Well, I was in college 1957-63 and there were libraries where I could have researched T1D. Maybe Dr Joslin's book was there? I might have visited larger cities in Virginia and searched for a doctor who was more knowledgeable about my diabetes. I did visit a doctor in Richmond in 1970. He was the one who told me my life expectancy would have me die before I was 40. I was 31 at the time. HA! I hate doctors who use scare tactics!!!
My management in the 1945-1995 years left a lot to be desired, and I cannot help but feel guilty about that. There were things I could have done to learn more, but ignorance prevailed, and I did nothing. Well, I avoided sugar, and that was the only advice my doctors gave me during my early years. I ate tons of food, all kinds, but avoided sugar. I thought I was doing everything appropriate to avoid complications.
I joined online diabetes support groups starting in 2006. There were some T1Ds who had been on diabetes message boards as far back as the mid 1990s. Why didn't I know about them? More guilt. Some of my long term online friends have known about carbs and carb counting many years before I did. Their diabetes management was so much better than mine until the current century. More guilt. I felt so grateful to find so much wonderful information online and I have had much better control.
More recently I have forgiven myself for these feelings. I have been a T1D for 71 (edited) years, and the only diabetes related complication I have is some mild nerve damage. Even if I knew all the things I know now during my early years, I might not be any healthier. It is time I stop feeling guilty. Sometimes I feel guilty for having felt guilty in the past, but that is a forgivable kind of guilt. :)

Thursday, March 9, 2017

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. 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 200. The average is 106, but there are numbers that indicate unhealthy highs and lows.
Patient B has test results 72, 80, 94, 100, 106, 120 and 148. The average is 103, but the data is more closely packed, and none of the numbers are undesirable.
Patient B is experiencing better control, and is 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 106. Patient B had smaller deviations from the average of 103, so the SD was much better. I try to keep my SD as small as possible, but it is difficult to do. My A1c's have been in the 5.4-6.4 range for almost 15 years (The graph below shows my A1c's for the years 1980-2015). When I have too many highs and lows, my SD is higher and I can feel neuropathy symptoms. I used to have some spots of retinopathy in both eyes when I had a roller coaster control, even though my A1c was good. My using an insulin pump helped reduce the number of highs and lows.
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 reducing the highs and lows.
I have had A1c's no higher than 6.4 for almost 15 years, but I had the beginning stages of neuropathy and retinopathy about 12 years ago. My control had been tight, but it was necessary to make it even tighter. I stopped having so many highs and lows. After a few months had passed, the retinopathy disappeared. The neuropathy is still present in my feet and legs, but I rarely experience any pain. If I have high blood sugar for many hours there is sometimes mild pain during the night. I have been a type 1 diabetic for 71 years, and have not had any serious complications. I want to keep it that way!!

History of Insulin

The following link gives an updated version of the History Of Insulin from dLife.com. When you have finished the first part (video), click on additional parts in the right hand margin. There are many great videos here on insulin and diabetes. WARNING: There are some graphic scenes in these videos

Staying Between The Lines

"Staying Between The Lines", by Riva Greenberg​

Riva is one of my favorite authors for her articles, blogs, and books on type 1 diabetes. The article/blog below is one of the best I have seen on day-to-day care of adult type 1 diabetes. You can learn a lot from Riva. She and I had a long phone conversation a few years ago. You might want to look at her books, they are excellent. Click on the link below, to see one of her excellent articles.

Friday, February 24, 2017

My Diet

I know so many type 1 people who eat very healthy, low carb meals. That certainly helps with the control of blood sugar levels, but I do not find that to be necessary. For so many years, starting in 1945 when I was diagnosed, I ate anything I wanted as long as it did not contain sugar. My portions could be as large as I wanted. Not eating sugar was my only limitation. My typical day saw me eat hundreds of carbs, many of which were very fast acting. That was poor diabetes management, but my parents and I did not know any better. My doctors knew very little about diabetes back then. I am very fortunate that my diet back then has not caused any serious complications.
At the present time I eat an average of 150-160 carbs per day, and my A1c's have been in the 5.4-6.4 range for fifteen years. Here is a typical day in my schedule:
8:30 AM....A slice of bread (9 carbs) toasted with sugar free jelly (5), a slice of ham, mixed berries (16), a half cup of coffee (2).....total....32 carbs
12:00 noon....A medium size baked potato (30), a pork chop, a small amount of gravy (5)....total....35 carbs
2:00 PM....Before going to the gym for a one hour workout....an ice cream cone (chocolate) with sugar...(25)...only a one unit bolus since I was going to get a lot of exercise
5:00 PM....Five corn chips with salsa (13)
7:00 PM....Pastrami sandwich with mayonnaise, slice of cheese, and slice of tomato... the bread has 9 carbs per slice...(20)....cottage cheese (6)....strawberries (10)...half cup of coffee (2).....total....38 carbs
10:00 PM....My BG was 77 so I needed a small snack....peanut butter and crackers (12)
TOTAL for the day....155 carbs
I never eat anything with sugar (table sugar) unless I am going to get exercise afterwards, or I have a low. I carry a small zip lock bag of jellybeans or skittles with me when I am away from home.
Note: There is really no typical day for my meals, I like a lot of variety so no two days are the same. As long as my diabetes management is stable, I see nothing wrong with that. My A1c is good, and I am not overweight. I like variety in food, TV programs, movies, activities, exercises, and most all things......but not women. My wife is wonderful and I do not need variety there. LOL!!!

Tuesday, February 21, 2017

Commitment

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 blood tests lower, and more stable. Why didn't my doctors tell me that? 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, and I stopped eating some foods. There were more rules to follow, and things became more complicated. Then there was using my first meter in the 1980s, basal and bolus insulins with carb counting in the 1990s, and my insulin pump in 2007. 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 myself 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 2006-2007. 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 71 years of type 1 with no complications except some neuropathy, and other minor nerve damage. I do not need any medication for that, and I am very fortunate that having only the "no sugar" rule for so many years has not caused me any major problems.
I am definitely committed to being committed. Perhaps diabetics who are not committed should be committed to online diabetes support groups! :wink:

What does commitment mean to you?

Monday, February 20, 2017

Only In America

Only in America ......do drugstores make the sick walk all the way to

the back of the store to get their prescriptions while healthy people
can buy cigarettes at the front.
Only in America ......do people order double cheeseburgers, large
fries, and a diet coke..
Only in America .....do banks leave vault doors open and then chain
the pens to the counters.
Only in America ......do we leave cars worth thousands of dollars in
the driveway and put our useless junk in the garage.
Only in America ..........do we buy hot dogs in packages of ten and
buns in packages of eight..
Only in America .....do they have drive-up ATM machines with Braille lettering.
EVER WONDER ...
Why the sun lightens our hair, but darkens our skin?
Why can't women put on mascara with their mouth closed?
Why don't you ever see the headline 'Psychic Wins Lottery'?
Why is 'abbreviated' such a long word?
Why is it that doctors call what they do 'practice'?
Why is lemon juice made with artificial flavor, and dishwashing liquid
made with real lemons?
Why is the man who invests all your money called a broker?
Why is the time of day with the slowest traffic called rush hour?
Why isn't there mouse-flavored cat food?
Why didn't Noah swat those two mosquitoes?
Why do they sterilize the needle for lethal injections?
You know that indestructible black box that is used on airplanes? Why
don't they make the whole plane out of that stuff?!
Why don't sheep shrink when it rains?
Why are they called apartments when they are all stuck together?
I like this one!!!
If con is the opposite of pro, is Congress the opposite of progress?
If flying is so safe, why do they call the airport the terminal?

Thursday, February 16, 2017

Type 1 Diabetes, Bone Density

Long Term Type 1, Bone Health Protection
The Joslin Medalist Study has examined more than 1000 people with 50 or more years of Type 1 diabetes. The purpose of the study is to find what makes the medalists different from so many other type 1 individuals who have had diabetes related complications. The study began in 2005, and is ongoing. I participated in the study in 2009. In 2011, I attended a medalist meeting at the Joslin Medical Center. Dr King, head of the project, announced that a large group of the participants in the study have some kind of "inner protection" that has prevented them from having any serious complications with their eyes, kidneys, and nervous systems. He also said that the inner protection does not protect our hearts, and that we should do our best to have good heart health. Many medalists have had heart by-passes. I have been type 1 for 71 years, and except for some very minor nerve damage, including neuropathy , I do not have any of these complications. My heart is also in good shape.
A study of a subgroup of these participants was done at the Bone Density Center of the Mass General Hospital. It was determined that the long term diabetics examined have a protective factor preventing bone health deterioration. The following abstract shows the details of the subgroup study:
Protection from Fracture Risk in Long Term Type 1 Diabetes: 50- Year Medalist Study
HILLARY KEENAN, SARA TUREK, STEPHANIE HASTINGS, GEORGE KING, Boston, MA.
Abstract:
Individuals with type 1 diabetes (T1D) have demonstrated a 12-fold increased risk of fragility fractures over their age-matched peers. As hospitalization for fracture is highly associated with decreased quality of life, morbidity and mortality this is an important, yet little studied diabetic complication particularly amongst those with extreme duration T1D. The 50-Year Medalist Study has extensively characterized over 800 individuals with a mean age of 69 y and duration of 55 y of T1D. Early examination of self-reported rates of hip, vertebral, and wrist fractures show extraordinarily low rates (0.33%, 0%, and 1.7%, respectively) in stark contrast to the 12-fold increase expected. To further examine these findings, 55 participants received DXA scans, 29 females, 26 males with a mean ±SD HbA1c of 7.2±0.8% and 7.0±1.2%, age 62.1±6.5 y and 66.7±6.8 y, and duration of 52.9±2.7 y and 55.8±5.1 y, respectively. BMI for this age group was low with 25.0±5.2 kg/m^2 for females and 27.3±4.4 kg/m^2 for males. T-scores, indicative of risk for fracture, for female 1/3 radius (1/3R) was -1.1±1.3, lumbar spine (LS) 0.1±1.2 and for the femoral neck (FN) -1.3±0.8. For males the 1/3R, T-score was -1.1±1.3, the LS was -0.1±1.9, and at the FN -1.3±0.8, none in the osteoporotic range. Total vitamin D, D2, D3 and calcium did not correlate with T scores among female or male, except for D3 among male and the LS T-score (R=0.5, p=0.03). There was no association of T scores with HbA1c, BMI, age or duration in either gender, p>0.05. As BMIs were low in male and female, the lower than expected risk T scores are likely not due to increase weight bearing as seen in T2D patients. These pilot data demonstrate protection from fracture, and low risk in this group with long term T1DM suggestive of a protective factor preventing bone health deterioration.

Tuesday, February 14, 2017

Diabetic Cheiroarthropathy

I read about a new complication today..."diabetic cheiroarthropathy".

"Diabetic stiff hand syndrome, also known as diabetic cheiroarthropathy, is a disorder in which finger movement becomes limited as the hands become waxy and thickened."

I had carpal tunnel and ulnar nerve surgeries more than twenty years ago, but this stiff hand problem is a little different. I am having carpal tunnel trouble again, in both hands. I may need more surgery, soon.

I have seen discussions abut trigger finger problems. It is very common, and a simple surgery corrects that. I have occasional trigger finger problems. It occasionally occurs when I have very low blood sugar, but it is corrected when my blood sugar is corrected.

"A typical technique for diagnosing diabetic stiff hand syndrome is to hold your hands together, both palms touching.
If the skin and joints of each hand cannot touch each other, or if there is a gap between the fingers and palms, then you should consult your doctor."

More discussion of diabetic cheiroarthropathy appears in the link below.

http://www.diabetes.co.uk/diabetes-complications/stiff-hand-syndrome.html

Saturday, February 11, 2017

Beautiful Writing, Type 1 Blog

The following blog was written by Jess Drexler, a 22 year old type 1 diabetic, diagnosed at age 6. It is a masterpiece, such beautiful writing, I wish I could write like that. I have her Mom's permission to share it here.
"Cold hard truth. In the palm of one hand I am holding
one bottle. It is a bottle of Novolog fast-acting insulin. In the other, I am holding one 50u syringe, drawn back to the fourth marker with no breach, because I have become an expert in transporting air bubbles back into the air[a]. But, for a diabetic, it is not just about the medicine. It is the intricacy and the intimacy we develop with the illness, finding ourselves reasoning with her, or begging for her to stop. It’s in the fridge, cupboards, and cabinets, and it is the clear liquid that my life teeters on. Diabetes poses a very humbling reminder every time we get up in the morning. The one thing that can kill us is also the one thing that keeps us from dying, and I’m holding it in my hand.
I still remember the last night I spent alone, before this world of vials and syringes.. It was dark outside, so the lights inside created a little reflection on the window of my small, 28 pound, 6 year old body. The street lights were illuminating a visible shape from the shadows to the pavement. I saw the bugs dancing around the streetlights in their own crazed rhythm. They’d enter the shadows and go unseen, but then the light would sweep them up again, flying in intricate circles and bumping into each other, fighting for the light. I always wondered why those bugs wanted the light so badly, but only came out at night[b].
I didn’t know that would truly be my last moment I remember, being alone.
Now, we are always together, I am always with her; we share the same body, the same home. 17 years. That’s 204 months, 886 weeks; that’s 150,000 consecutive hours we’ve spent, body-to-body, sharing the air around us.
When people ask me how I can do it, I lie.
I don’t say that I still hate every shot as much as I hated the first one when I was 5 in a white room in the pediatric unit[c]. They would grab my arms by my wrists, and pin them above my head on the white pillows, and next my ankles, until I couldn't wiggle my way free. Then the nurse would enter, with that seem[d]ingly sinister smile, holding the syringe, she’d creep up to me. I knew I couldn't escape the fear, all I could do was try to understand it. After a couple days, I understood. I understood that arguing, fighting, and running away wasn’t going to set me free, I understood that kicking and screaming wasn’t going to change anything. But,when people say “I could never do that,” or “that looks like it hurts,” I tell them “well, you do what you have to do.” But this isn’t the truth, none of it is. It does hurt, the needles and the pokes and sticks don’t get more pleasant as the days go by.
But you begin to understand, you begin to see what it is truly like, to not have a choice.
So, when people ask me about my diabetes, without having a clue about it, I lie. Because maybe, the truth isn’t what they want to hear.
Maybe it is because I can’t say it’s inconvenient having to make sure I have my phone and keys, wallet, monitor, test strips, short-acting insulin, long-acting insulin, syringes, lancets, and glucose tablets every time I leave to go somewhere.
I can’t say I almost died last weekend because I ran out of glucose tabs at my apartment[e].
I can’t say how shitty it is that I have to make the walk into bleach-greased bathroom stall and put one leg up onto the toilet to give an injection because I’m embarrassed to do it where people can see, where people can stare.
I don’t tell what it is like to have a needle fall out of your pocket in a gas station, and hit the floor like steel on a mirror[f]. I don’t tell them about getting pulled over, searched, and detained, for a needle, my lifeline, sitting on the passenger seat.
When people ask me how diabetes impacts me, I lie.
20,000 injections, 31,000 finger pokes, millions in medical bills, and a slew of misconceptions, and she shows no sign of stopping[g]. She doesn’t stop reminding me that she has control, that she watches my every move, my every moment, she is there, waiting for a mistake so she can slip inside[h]. She reminds me that I have to understand her better. She tells me I have to test more, I have to change my basal rates, or change my ratios, I have to study her and study myself, and never forget that I’m not alone. She keeps me up at night, aching for a drop of blood, or a half-filled syringe. Everyday, every hour, every second, since that night the bugs were dancing in the street lights, she is with me.
I have diabetes[i].
This is the truth[j].
Jess Drexler"