Monday, July 24, 2017

Powerful Description of Type 1

This is a very well stated post from Slaight Brad. A very powerful description of type 1 diabetes.
Slaight Brad
Diabetes is an autoimmune assassin. A traitorous coward that strikes with a sucker punch, leaving behind a dead or panting organ adrift in a sea of insalubrious self..
Diabetes is years of lancet jabs, eviscerating your fingerprints, disrupting the swirls as if to say “We’re taking everything from you, even the one thing that makes you unique.”
Diabetes is a suspicious stare and judgmental eye from the faces of so many of those we meet.
Diabetes is the sadness of a blue candle, its frenetic flickering flame pays tribute to a life lost
Diabetes is the empowering color blue…as in blue circles, blue Fridays, blue heels, and big blue tests.
Diabetes is the number 300 and the number 40 all within a few hours. It’s pump or be pumped, control or be controlled, inject or die.
Diabetes is a carbapalooza gorge-fest because you’re tired of your life being measured in grams. The protest rages for hours as you devour everything like a ravenous termite in a lumberyard
Diabetes is the useless advice, cured laboratory mice, a dozen meters that are not precise, as you pay the price so corporate execs can live real nice
Diabetes is the endless stories from people who feel the need to tell you about their diabetic uncle who lost a toe, lost a foot, lost a leg
Diabetes is an unknown surgeon in 1920’s Canada who unlocked a miracle and then gave away all his rights to the discovery because sometimes humanity actually does trump greed.
Diabetes is an Einsteinium formula in restaurants and supermarket aisles as you do the mathematical dance called the carb ratio two step
Diabetes is a never ending parade of doctor appointments as you try to distract your fear by thumbing through six month old People magazines.
Diabetes is waking up in the morning knowing you still have diabetes and today is just like yesterday making you feel like an extra in some sort of a real life ground-hog day movie
Diabetes is an online community with people who get you, bloggers who represent, strangers in common who quickly become friends
Diabetes is the boy in back of a classroom, hoping he doesn’t lose one more friend because their clueless parents think he’s contagious
Diabetes is dinner parties with the usual diabetes police interrogation as you reach for a piece of anything. “Yes, I should be eating that. So back the (bleep) off!”
Diabetes is a Type 1 mother; as she prays that the finger sticks and Banting juice she’s known for so long will never be a part of her child’s innocent life
Diabetes is a trail of used test strips that follow you like Hansel and Gretel bread crumbs as you make your way through your own fractured fairy tale
Diabetes is a late night poet vomiting empty angry words in a ketone rage as he waits for the number to come down before he can even think of sleep
Diabetes is every minute of every hour of every day …and never knowing how many of those we have left
Diabetes is….the ultimate suck.
Diabetes is this and so much more…but mostly
Diabetes is…still without a cure!

Saturday, July 22, 2017

Diabetic-ketoacidosis

This is an excellent article from Diatribe on DKA (diabetic-ketoacidosis).

Did you know that:

...."after the discovery of insulin in 1920 the mortality rate for DKA
dropped to below 30 percent within 10 years, and now fewer than 1
percent of those who develop DKA die from it, provided they get
adequate care in time."

...." Somewhere between 5 and 8 of every 1,000 people with type 1
diabetes develops DKA each year, resulting in about 135,000 hospital
admissions per year."

...."It’s possible to check ketone levels with a simple,
over-the-counter urine test strips or a ketone meter. It’s a good idea
to start checking ketone levels when blood glucose is over 240 mg/dl."

...." as many as 30% of children with type 1 diabetes learn they have
the disease only after developing DKA."

The article below discusses the symptoms, risks, prevention and treatment of DKA.


https://diatribe.org/diabetic-ketoacidosis-explained

Thursday, July 20, 2017

Minimed 670G Pump

The new Minmed 670G insulin pump has artificial pancreas technology. It will "keep you in target by automatically delivering 'micro boluses' or withholding insulin" as needed. I will let you try it out, and I will wait and see how you like it. I'm chicken. I don't like the idea of a pump making decisions that I am presently making myself. If it works as advertised, it will be a wonderful pump. Then I will be jealous while using my new Minimed 630G pump, which does not have the same features.

Wednesday, July 19, 2017

Retinopathy

This is a very good article on retinopathy from the GLU website.
I was diagnosed with retinopathy about twelve years ago. I had a few spots in both eyes. My ophthalmologist said that he would have to use laser treatment if it did not improve. The spots were in my path of vision, and laser surgery would cause "holes" to appear in that path. The spots kept disappearing, and then reappearing as I saw the doctor every six months. Then I started using an insulin pump in June, 2007. My control was much more steady, with fewer lows and highs. I was having higher lows and lower highs than before. My A1c's had been in the 5.4-6.0 range for several years, but diabetes complications can occur even when the A1c is good. The roller coaster control with a lot of highs and lows can cause trauma to the body that cause the complications. With my pump, and a more steady control, my retinopathy disappeared, and has not returned. Pumping, and now a CGM, has given me much better diabetes management. I doubt that I will ever have retinopathy again.

Saturday, July 15, 2017

Bad Luck With Doctors (Part 1)

I started seeing doctors while having T1D symptoms in 1945. The first three doctors we saw did not have a clue. A fourth doctor had my blood tested, and made the diagnosis. He admitted that he was not the right doctor for me, so he recommended a fifth doctor who supposedly knew much more about diabetes. Dr. Davis got me started on animal insulin, and my health improved. I had lost so much weight, and I was not able to walk. I left the hospital with weight gain, and walking normally. I felt great. We thought that Dr. Davis was the best doctor in the world!
During the following weeks I was told that I should never eat sugar. Just test my urine in the morning, and take my shot of insulin. No more urine testing or insulin until the next morning. There were no other instructions. Everything actually went well during the months and years that followed. There were some seizures at night, but my mom became an expert at handling that problem. We did not realize that there were doctors in other parts of the country who knew much more about diabetes. I was very lucky to survive and thrive without the knowledge I needed. So many people were dying from diabetes back in the 1940s.
I saw general practitioners (GP's) 1945-1977, and none of them knew much about diabetes. I had not heard of endocrinologists during those years. I wonder when endocrinology and diabetes specialists began? I continued to survive and was very healthy. The crude devices I was using, and the animal insulin were working very well. Many diabetics were not so lucky.
I was married in 1964, and my wife and two young sons moved from Virginia to New York in 1970. My wife was very good at assisting me when I needed her. My diabetes management routine did not change until 1977 when I started seeing an internal medicine doctor. Dr. B knew so much about diabetes, and he taught me many useful things. Why did I have to wait 32 years to find a doctor like this? (Dr. B is not the Dr. Bernstein you may know.) My Dr. B started A1c's for me in 1980, and I knew so much more about getting better control with my BG levels. My A1c's were initially in the 10-13 range, but soon they were in the high 5's. My A1c's stayed in the 5.4-6.0 range for many years. Dr. B diagnosed my insulin resistance (IR) in the 1990's and prescribed an oral med to help me. I had gained a lot of weight, and the oral med helped me to lose most of it. My IR was under control, and all seemed very good at that time.
(To be continued another day.)

Sunday, July 9, 2017

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. (Note: There is another report that Type 1 and Type 2 were names given in 1970.)
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.
"The term ‘double diabetes’ was first coined in 1991 based on the observation that patients with type 1 diabetes who had a family history of type 2 diabetes were more likely to be overweight and rarely achieved adequate glycaemic control even with higher insulin doses. The more extensive, or stronger, the family history, the higher the dose the patient received."
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 was predisposed to become type 2. The predisposition 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 34 pounds. I initially used avandia for my IR, but started using metformin 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 nineteen pounds, and was only four pounds above my ideal weight. Despite the weight loss, I still had IR. Metformin, eating an average of 140-150
carbs per day, and getting lots of exercise kept me in good health. My A1c's were typically below 6.0, and except for some neuropathy, 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.
A type 1 diabetic with IR has double diabetes, but is NOT both type 1 and type 2. That person is type 1 with a type 2 characteristic. That is not the same as having both types of diabetes.
If you are type 1, you gain a substantial amount of weight, and you have type 2 relatives, you might want to discuss your situation with your doctor. You may have insulin resistance. You may have double diabetes.

Wednesday, July 5, 2017

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 71 years with T1, and have no diabetes related complications except for neuropathy. There are many other type 1 diabetics like me in the US who have lived with their diabetes for 50 years, and some for as much as 80 years.
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 Dlife.com 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, at that time, 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 many 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.

Tuesday, July 4, 2017

Friends For Life Diabetes Conference

Jeff Hitchcock, Anita Vaughn, Richard Vaughn, Tom Karlya, and Laura Billetdeaux at the Friends For Life Conference in 2015. I wish I could be there this year. This is a wonderful conference for type 1 folks of all ages, and their families . I have attended twice, in 2013 and 2015. Maybe again in 2018?


Friday, June 30, 2017

My Joslin Medalist Study Particiation

My Joslin Medalist Study Participation
A few weeks ago I received a letter from the Joslin Diabetes Center saying a smaller group of the previous participants were going to be tested again. They wanted to see some of us who had been tested at least five years ago, and determine how we are doing after that gap in time. My first participation at Joslin was December, 2009. I completed my second participation in the Joslin Medalist Study this week on Wednesday, June 28.
I fasted for ten hours before the testing began. I had not taken any bolus insulin during that ten hours. I entered the testing room at the Joslin Center at 7:30 AM. After several blood samples were taken I was told to suspend my pump so there was no basal insulin. Then I drank a big glass of a glucose mixture. After drinking the glucose my blood was tested every 30 minutes for the next two and a half hours. At that time it was 10 AM and my BG was 406. I felt very sick. Then I was told to take a correction bolus. The reason for the GTT ( Glucose Tolerance Test) is to see if there is any reduction in the blood glucose level during the 90 minutes after drinking the glucose mixture. Many participants did see their levels reduced during that time. This indicated some insulin was being produced within the participant's body. That did not happen with my GTT, my BG kept increasing, so I do not produce any of my own insulin.
My wife and I walked the halls and rested during the next ninety minutes, while waiting for my appointment at the eye center on the first floor of the building. The eye study began at 11:30 AM. My BG was still very high at that time, and I was not feeling good during the eye examination, but I don't think that influenced the outcome. This eye exam was much more thorough than the one given during my first medalist study participation in 2009. The results were great! The eye specialist told me that my eyes are amazingly good for someone who has been type 1 for 71 years.
I do have some bad neuropathy in my feet and legs, but my eyes, kidneys and heart are in good shape.
There were 1020 participants in the initial study (2005-2015). After the first 500+ participants had been tested, it was found that more than half of them were still producing some of their own insulin. Those individuals were producing only small amounts of insulin, but any amount might be helpful in helping to prevent diabetes complications. They are still insulin dependent, and type 1.
It has also been found that some medalists who were not producing insulin on the first visit, as shown by the glucose tolerance test, were then producing insulin during their second visit. This suggests that some of us have a "sporadic" or an "on again-off again" situation with insulin production. I was not producing insulin on either of my visits.
I am very grateful for having the opportunity to participate in the Joslin Medalist Study on both occasions. The study was free since it is part of the research being done at the Joslin Center. My hotel stay for the previous day was also paid by Joslin. It was an easy four drive from our home in Kingston, NY.
I applaud the Joslin Diabetes Center for doing this research. Dr. George King, head of the Study, hopes that the factors will be found that have enabled so many of us long term type 1 diabetics to avoid any serious diabetes related complications. Such a find might result in a treatment that would help younger type 1 people to live a long life without any serious complications.

Saturday, June 24, 2017

Participation, Joslin Medalist Study

I will be participating in the Joslin Medalist Study for the second time on June 28. There were 1020 participants in the initial study that ended in 2015. Now a smaller subgroup of those participants are invited to return for follow-up testing. The follow-up visit "will confirm the ongoing presence of the protective factors against diabetic complications and the ability for the body to continue making insulin." Those are the words from Dr. King, head of the Study. My testing in 2009 showed I was not producing any of my own insulin, but many of the medalists are producing a significant amount of insulin. They are insulin dependent, but the amount of insulin they are producing must certainly help explain why they have such good diabetes health after 50+ years of type 1. One interesting fact recently received from another medalist who has completed her follow-up visit is that some participants were not producing insulin during their first visit, but they were producing insulin during their second visit. That is why I will be having a GTT (Glucose Tolerance Test) and a C-peptide test for my second visit. If I am still not producing any insulin during my second visit, my good health must have some other explanation. I will get a very thorough examination, with many blood tests, heart exam, eye testing, etc. This is a free testing routine being done at one of the best diabetes centers in the world, and it will last about seven hours. I will receive a report of the results at home several days later.
The picture below is a seasons greetings card. Participants receive those cards each year in December. The picture shows some members of the Joslin Medalist research team. Third and fourth from the right are Drs. George King and Hillary Keenan, who head the study. The other people shown are doctors, researchers and staff members. Maya Khatri, second from the right, will oversee my study participation on Wednesday, June 28.
We are packing for our four hour drive to Boston. We will be meeting some of my Facebook friends while we are there.


Thursday, June 22, 2017

Joslin Medalists...Video

I recently posted that I attended the Joslin Medalist Meet-up in Boston in 2011 There were approximately 120 Medalists there, all of whom had been T1 for 50 years or more. One man there had been T1 for 84 years, and was 90 years old. Kerri Sparling was there as a guest, and she prepared this wonderful video after interviewing several of the medalists.

https://www.youtube.com/watch?v=OxCpQqjLRo8

Sunday, June 18, 2017

Joslin Medalist Study....Part 2

In June, 2011 I attended a meeting of more than 100 medalists at the Joslin Diabetes Center. Drs. George King and Hillary Keenan head the Joslin Medalist Study. Dr. King presided over the meeting on Saturday, June 4, 2011.
The picture of the more than 100 medalists appears below. If you look in the back row, in the middle, at the guy standing taller than the rest, that is me. I am 6' 2" and towered over almost all other medalists. There are several younger people in the picture who are not diabetics. They are doctors and staff members who were attending. The following link gives some details about that meeting, and some things said by Dr. King.
There are common themes among the more than 650 people in the Joslin Diabetes Study. According to Dr. George King, Joslin’s research director, these survivors are typically:
* of Northern European ancestry, which tends to correlate with high socioeconomic status, high levels of education, and good health care and nutrition.
* nonsmokers.
* physically active.
* children of parents who took control of their diabetes when they were very young, and they continue to do a good job of keeping their blood sugars low and stable.
* children of parents who were long-lived — on average, 76-77 years.
* matter-of-fact about their diabetes: They see it as an annoyance, but not a curse.
* willing to participate in medical research about type 1 diabetes.
* have a pancreas that has continued to make insulin-producing beta cells.
These themes were flashing on the screen as we entered the auditorium where the meet-up was held. I satisfy every theme but the last one. My C-peptide numbers on three occasions show that I do not produce insulin. Many of us gave short talks during the meeting. When I spoke I pointed out the fact that I do not produce insulin, and concluded that there must be factors other than insulin producing beta cells that explain longevity and good health for some of us.
Some of the things I carried away with me are as follows:
** The number of cases of type 1 diabetes being diagnosed in children under six years of age is rapidly increasing.
** There are approximately 2000 type 1 diabetics in the US who have lived long and have the protection, to varying degrees, shown by the medalists being studied. There are roughly 2 million type 1 diabetics in our country, and I'm sure many of the millions of younger type 1 diabetics will become Joslin Medalists and will be found to have this protection too.
** The medalists have protection against complications in their eyes, kidneys, and their nervous system, however, this does not apply to their hearts. We were told to take very good care of our hearts.
"Clues to this protection may be found in analyses of a family of proteins called advanced glycation end products (AGEs), which are increased by high blood sugar levels. In the study, subjects who exhibited two specific AGEs were more than seven times as likely to have any complication. But this study also demonstrated for the first time that a combination of two other AGEs is associated with protection against eye disease."
Dr. King told us that these proteins, and many others as well, will be carefully examined in the next phase of the Medalist Study.



Saturday, June 17, 2017

Joslin Medalist Study...Part 1

There is a major research project going on in Boston called the Joslin Medalist Study. The Study began in 2005, and is now in its thirteenth year. Every participant in the Study has been a type 1 diabetic for 50 years, or more. I have been type 1 for 71 years, and participated in the Study in 2009. They hope to find the factors that have enabled us long term diabetics to live so long without any serious complications. If found, that could lead to a treatment that could be used by young type 1 diabetics, so they could have long, healthy lives, too. The Study is ongoing and is funded by JDRF and NIH.
I participated in the Study in 2009. It was very thorough, and detailed. During the days before my wife and I drove to Boston, I was required to fill out many pages in a report describing my background, and my physical condition. In December I turned in my written report, and was given a very thorough physical examination. Many blood samples were taken. The examination took almost seven hours, starting at 8 AM after fasting overnight. I was told to take my basal insulin, but no breakfast and no bolus insulin before the examination began. I was required to drink a large glass of a glucose mixture for a GTT (Glucose Tolerance Test). My blood sugar was then determined every 30 minutes for the next two hours. My BG reached a high in the 300's. I felt very sick since I had not seen a BG that high for many years. At that time I was allowed to take a correction bolus. Some participants showed a drop in their BG after two hours, showing that they still produce some of their own insulin. It was obvious that I was not producing any of my own insulin. A C-peptide test helped confirm my lack of insulin production. I was then given a very lengthy eye examination. It took until late afternoon for my BG to reach a normal level. We left the Center around 3 PM, and we had dinner early that evening. That was the first food I had eaten since the previous evening. We drove home the next day. I did receive a report giving the results of my examination. It was a good report, but it included my having some neuropathy in my feet. I had been previously diagnosed with neuropathy by my neurologist in Kingston, NY. No other significant findings were in the report.
In 2010 it was reported that some medalists still produce some of their own insulin. The following link gives the details:

Tuesday, June 13, 2017

Adult Onset Type 1 Diabetes

This article offers a very good discussion on Type 1 diabetes diagnosed in adults.

"....the medical community has been slow to recognize this, and Type 1 diabetics diagnosed as adults are still treated as abnormalities and frequently given inappropriate treatment for the disease they have. All too often, they are diagnosed with Type 2 diabetes, which is a fundamentally different disease not only clinically but genetically.... and the methods of treatment for the two diseases are also different. The misdiagnosis typically results in under-treatment, and causes needless suffering."

http://adultt1diabetes.blogspot.com/2017/06/from-2000-my-first-published-article-on.html?utm_source=feedburner&utm_medium=email&utm_campaign=Feed%3A+AdultOnsetType1Diabetes+%28Adult+Onset+Type+1+Diabetes%29

Sunday, June 11, 2017

Is Type 1 Diabetes Always Autoimmune?


I had 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 am not aware that I ever had that test, until last year. I asked my endocrinologist to have the test performed. I had that test last year, and I am autoimmune. 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. I do not have any relatives who are/were T1, so I feel my T1 is not genetically induced.
Here is the link to the GAD65 test:
I have a Facebook friend with idiopathic diabetes, also known as Type 1b diabetes. "This form of type 1 diabetes is not autoimmune in nature, and tests for islet cell antibodies will come up negative. People with type 1b have an insulin deficiency and can experience ketoacidosis (a high blood sugar emergency), but their need for insulin injections typically waxes and wanes over time." My friend's blog about her type 1b diabetes appears below:

Wednesday, June 7, 2017

Good Health After 71 Years of Type 1, How Is That Possible?


In one of the diabetes support groups I was asked if I attribute my good health in my early years to my sugar free diet. My doctor, when I was diagnosed in 1945, told my parents that I should not eat anything sweetened with sugar. That was the only advice I had to follow for many many years. I was scared of sugar, and I followed that rule very carefully. We thought that as long as I avoided sugar, I would be fine! There was no mentioning of possible diabetes complications. There was no stress during those years, just aggravation with the lows I would have when I exercised too much, and the occasional seizures I had while sleeping. My mother prepared wonderful desserts sweetened with saccharin. I did not feel that I was missing out on anything important. I did eat a lot of food that had fast acting carbs, but I did not know that carbs had anything to do with diabetes until 1988. I think that avoiding sugar did help, but all the bread, milk, cereals, fruit and those desserts mother prepared were causing very high urine sugar. Those foods did not contain actual sugar, so we thought they were okay for me.
I did not have a meter to measure blood sugar until the mid 1980's. That was 40 years of not knowing my BS (blood sugar) numbers. I felt very good, and was very healthy, with no diabetes complications. In 1970 I saw my first doctor who was a diabetes specialist. I was given a blood sugar test when I arrived at his office building. They were able to do an in-office test on the blood sample without having any device like we have now. When I entered his office he told me my BS was very high, and he handed me a book. He told me to pay attention to a particular page. My visit with that doctor was no more than five minutes. I was out the door and leaving a big waiting room filled with patients. I sat in my car and looked at the page the doctor recommended. The page had two columns. On the left was the age at diagnosis, and on the right was the estimated age at death. My life expectancy was very alarming! That time was 24 years after diagnosis, and the book suggested I would die while in my 40's. I felt I had another 10 years to live, but maybe not much more than that. That was the first time that I was depressed because of my diabetes. I took the book home with me, and showed it to Anita, my wife. We had a long talk that evening. I was so healthy after 24 years of diabetes, and there was an estimated 10-20 years of life left for me? We had two boys at that time, one less than a year old, and the other 3 years old. I thought I might be leaving my young kids without a father, and my wife having to support them. I did not sleep much that night. My wife and I decided that that book was giving me false information. Given my very good health, it could not be true. I tossed the book, and never read the rest of its content. I think that there may have been other bad news in the book, possibly a discussion of the diabetes related complications. That would have made me even more depressed, so I am glad I tossed the book.
We moved from Virginia to New York that year, and I started teaching math at a community college. Life was great, and we loved New York. The book I tossed was of very little concern to me then, I had no worries about dying in my 40's. Well, maybe a little, but I did not discuss it with Anita anymore. We were making mortgage payments on our home, and I thought we should have mortgage insurance. A local insurance company had me see a doctor for an examination. He was a very old, retired doctor who saw people who wanted insurance with that company. The doctor told me to pee on a test strip in the office bathroom. The strip was a very dark green, almost black. That indicated very high urine sugar. I had been using strips of that tape for many years at home, and the dark green color appeared very frequently. The doctor said he could not approve me for the mortgage insurance. That decision was made based on one urine test. Really? So ridiculous! The doctor followed me to my car, parked in front of the building. He told me about a former patient who had very good health with diabetes, and then the following year he had terrible kidney problems and died. The doctor said that blindness and kidney problems happened with that patient in that year. He told me that I should prepare my will ASAP. He knew I had a wife and kids, so I suppose he was actually giving me good advice. I told Anita about my day, and we did not let it bother us very much. The earlier experience with the previous doctor made coping with this situation much easier. The next day I visited the local office of Metropolitan Life insurance. They got word from my local doctor, and realized I was in good health, with no diabetes problems. My mortgage insurance was approved. Our mortgage was paid off in 1995, and I was still healthy, with no complications.
I have often wished that I had not seen the doctor in Virginia, and that Metropolitan was the only insurance company that I asked for mortgage insurance. Things would have been so much better!!
Now I am 77 years old, with 71 years of type 1. I have some neuropathy, and my neurologist says it is severe. I feel some numbness in my feet and legs, but very little pain. I do not need any medication, so I do not think it can be severe. A misdiagnosis? I take long walks and workout at a gym, with no problems. I do not consider my neuropathy to be a significamt problem. I do not have any other diabetes complications.
So what has caused me to live so long, and have such good health? I do think good genes has a lot do with my good health. There are many long term type 1 people like me with good health. Some of them have lived 75-80 years with type 1, and they are in very good shape. Most of the 1000 participants in the Joslin Medalist Study have been found to have good health after 50+ years with type 1. I attended a Joslin Medalist meeting in Boston in 2011. Dr. King, head of the Study, announced that many of us have a special inner protection that helps prevent problems with our eyes, kidneys and nervous system. He also said that our hearts are not protected in that way, and that we should be very careful with our hearts. I had a nuclear stress test a few months ago, and my heart is in great shape. Will this last for many more years? Dr. King and his research team are still looking for the source(s) of that special protection that so many of us, and so many of you have. If the source is found, maybe it will provide some kind of treatment that will prolong the lives of young type 1 diabetics, and enable them to live long healthy lives. 

Monday, June 5, 2017

Joslin Diabetes Medals

The Joslin Diabetes Center offers medals to people with type 1 diabetes who have completed 50, 75 and 80 years. There is also a certificate for 25 years.
Here is the link for applying for these medals. A printable form of the application appears on the link page.


Lilly Diabetes Medals

Lilly Diabetes offers medals for completing 10, 25, 50 and 75 years of Type 1. The program is called "The Lilly Journey Awards". The link below gives access to the form for applying for these medals.


Friday, June 2, 2017

Banting House in London, Ontario

Here we have Michael Hoskins on diabetesmine.com, giving a wonderful report about his visit to the Banting House in London, Ontario. This report is a well done description of the interior of the Banting House, with many very interesting tidbits about Dr. Banting's past. The pictures are great. Thanks, Michael!!

http://www.healthline.com/diabetesmine/visiting-banting-house?utm_source=Sailthru%20Email&utm_medium=Email&utm_campaign=diabetesmine

Wednesday, May 31, 2017

Bad Hypo On The Job

In the early 1980's I was teaching a class in basic Statistics at a community college. All students in the nursing program at the college were required to take the Statistics course. I was the only teacher there with a degree in Statistics so I taught most of the Statistics classes at that time. I taught many nurses through the years. In the summer of 198? I had about 25 students in a Statistics class, and 10 of them were nurses. It was an evening class. I left my office and started my walk to reach my class, and I had very blurred vision  I was very dizzy. It seemed to hit me so suddenly. I reached for my container of sugar in my pocket. It was not there. I recognized one of my students in the hall, and asked him to go to the classroom and tell my students I would be late. I fumbled in my pocket for change to use in the candy machine. No change. I had no one dollar bills to use in the machine. I should have gone to my class and asked for help, but I was not thinking clearly. I went outside to my car. The parking lot was rather dark, and my vision was so bad that I had great difficulty finding my car. I finally found the car and unlocked the door. I knew I had a roll of quarters I used for tolls. I grabbed the roll and headed back to the candy machine. It was not in the same building as my class. My hands were shaking, and I dropped several coins. My vision was so bad that I had to feel for the coin slot. I managed to get several coins in the slot. I could not read the letters and numbers so I just pushed buttons, and pulled knobs, until something dropped. I felt something, but did not know what it was. I wanted candy, but I had a big cookie with some sticky stuff between layers. I gobbled it down, and headed to the other building to meet my class. I was about 15 minutes late. I explained what had happened. The nurses were all over me for not asking them to help. A couple of them were perhaps in their late 30's, and had been nurses in a local hospital for several years. They were at my desk takiing my pulse, and asking me questions. The class started late, but I have always bounced back from these hypos very well. The class was about 2 1/2 hours long but it was ok that evening.

Two days later I had a terrible hypo during the night, and my wife could not get me to eat anything. I was convulsing and she called an ambulance. They were there promptly and gave me a much needed glucagon injection. I was hospitalized for two days. One of the nurses from my class waited on me there. Another nurse from my class kept dropping in even though she was on duty in another part of the hospital. That was a weekend, and I was back in class Monday evening. Everyone knew what had happened by the time I got to class. Those nurses took good care of me both in class and at the hospital. That was the only time in my many years of teaching that I had such help, or need of help, from my students.

I want to mention that this incident took place several years before I had my first meter for testing blood sugar. I did use Test-Tape for testing urine during those years. That was something I did at home, but on campus I relied primarily on my feelings. On the evening mentioned my hypo occurred very fast, and caught me totally unprepared. My diabetes did not really interfere very much with my job as a college teacher, but that evening with an awful hypo, teaching so long while recovering, and then spending two days in a hospital later that week is something I will never forget. That was the only time during my 71 years of Type 1 that I was hospitalized with a hypo.

Now I can test my blood sugar and use a CGM to keep this kind of hypo from ever happening again. That hypo and hospital stay was more that 30 years ago. Those nurses were so cool!!

Sunday, May 28, 2017

Scar Tissue & Insulin Absorption

When I was diagnosed in September,1945, 71 years ago, I do not think my doctor knew that I should rotate sites when injecting insulin. My parents were so good about listening to my doctor, and we followed his advice without fail. We injected into the muscle on my upper legs for many years, and there were always very high blood sugar reports from the doctor's lab every six months. I think that was because we were not using different body parts and rotating sites. Scar tissue had probably formed on my very skinny legs, even though the animal insulin I was using required only one injection per day. By the time I was in my twenties I was using my upper abdomen, and my blood sugar reports improved. There was no meter for measuring my blood sugar at home until the mid 1980's, so the biannual reports from the doctor's lab was the only thing I had to determine how I was doing. A1c's were not available until 1980.
In the mid1980s I had a meter and much better insulin. Several injections were required each day, and I was still using my upper abdomen. Eventually it became very difficult to push the needle into my skin. I actually had some needles bend, and had to get a different disposable syringe, reload and try a different spot. I had not been told that this might be scar tissue, no doctor had ever mentioned that. No doctor had suggested alternating sites. Maybe my doctors in the 1990s assumed I knew about this since I had been type 1 for 50 years at that time. In the new century I was using basal and bolus insulins, and doing as many as 8 injections every day. The toughness of my skin in my upper abdomen made it necessary for me to start using my lower abdomen and upper legs. It was common sense on my part that caused me to make that change. My blood sugar tests improved significantly, but I still did not know it was because I had moved away from the toughness in my upper abdomen.
In 2007 I started using a pump, and things were going very well until I tried my upper abdomen. I got a 'No Delivery' alarm on my pump and did not know what that meant, so I called the Medtronics help line. After a long discussion it was decided I had scar tissue. That was the first time I had heard those words. A very young sounding lady at Medtronics made that diagnosis, but my very experienced doctors had never mentioned it. This made me very angry, and it has taken me a long time to stop feeling bitter about it. At least one doctor should have told me about site rotation. I have permanent scar tissue in my upper abdomen and can never use it again. The skin will always be tough, and the insulin absorption almost nonexistent. I tried using my upper ab earlier this year, and saw very high blood sugar in the next few hours. I am presently using my lower ab and upper legs, rotating infusion set locations. If I don't change sets after three days I start seeing high blood sugar. That is because scar tissue is beginning to form there. I keep the sites about two inches apart, and change every three days. I have now had A1c's in the 5.5-6.4 range for about 15 years. Finding someone who told me about scar tissue has greatly improved my control. I will never know why I managed to avoid diabetes complications for the many years that I was not rotating sites, and having so much high blood sugar. I have some neuropathy , but my overall diabetes health is very good. That almost seems like a miracle to me.
I have frequently advised pumpers to rotate sites, and not use a site longer than three days. Most of my friends who pump are doing that, but I have met online pumpers who say they are using an infusion set for more than three days. One pumper says he uses sets for as much as a week, without having problems. I did not think that was possible. To keep scar tissue problems from occurring, and poor absorption giving very high sugar results, I strongly advise all pumpers to rotate sites, and avoid using a site more than three days. If the scar tissue is not so very old, then avoiding that body part will enable the area to eventually heal. If the accumulated scarring has occurred over a long period of time, then it may never go away. My upper ab is that way. Some people have lumps and sometimes larger amounts of it removed by surgery. Recently developed scarring can sometimes be helped by massaging.
I feel so lucky to have avoided serious complications after experiencing scar tissue and high blood sugar for so many years. I wish I could meet the young lady at Medtronics, and give her a big hug! lol

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.