Thursday, November 2, 2017

Blue November, Diabetes Month

    November is the official month for diabetes. Blue is our color, and JDRF is our organization. Let's make type 1 become type none!
    Type 1 for 72 years, but looking forward to new horizons, new technology, and a brighter future for all people with diabetes.





Saturday, October 21, 2017

Low Carb for Type 1?

Low carb for type 1?
I am type 1, diagnosed in 1945. I knew nothing about an appropriate way of eating. My doctor told me to take my insulin before breakfast and to avoid sugar, but there was no other advice given back then. I could eat anything I wanted, and as much as I wanted, if it did not contain sugar. I lived on a farm, and there was soooo much to eat. I drank milk from our own cows with every meal. We had an orchard with many kinds of fruit, and an acre of garden space. I ate tons of carbs every day, but I did not eat sugar, so my parents thought that was OK.
There was no device for testing my blood sugar until the mid 1980's. I survived and thrived that way for 50 years until the 1990's. I started testing my blood sugar with a glucometer, and before the dawn of the 21'st century, I was counting carbs and using a fast acting insulin. I began gaining weight. I had never been overweight until then. I was diagnosed with insulin resistance in 1998. Yes, type 1 diabetics can have insulin resistance. I started taking oral meds for the insulin resistance. With Metformin, eating an average of 130 carbs per day, and getting a lot of exercise, I lost all of the extra weight. My A1c's were in the high 5's and everything seemed good, but then I started having diabetes complications. Retinopathy and neuropathy were diagnosed. The roller coaster control, with too many highs and lows gave me a good BG average and A1c, but the complications were there.
I started using a pump in 2007. There were fewer highs and lows. My diabetes management improved so much that the retinopathy disappeared, and the neuropathy was not much of a problem at that time. My A1c's have remained in the 5.4-6.4 range for about 15 years. I am averaging 150 carbs per day, and I am not overweight. I am obviously not following a low carb diet, but my diabetes management is good. I am using a pump and a CGM, and my complications are under good control. Why should I follow an even lower carb diet? There are many type 1 people following a very low carb diet but I don't think a low carb is necessary for all diabetics. What do YOU think?
The following link gives an article written by Sysy Morales on diabetesdaily.com. It asks the question "Should all people with diabetes try eating low carb?" There are 50 replies to the article.

Thursday, October 12, 2017

Type 1 Diabetes 1900-1950

Dr. Joslin's article, Type 1, 1900-1950
Dr. Elliott Joslin wrote the following article in 1950. It gives a report on Type 1 diabetes for the years 1900-1950. It is very interesting to be able to compare the now with the then while reading this article. The first 21 years covered by the article were before insulin was discovered.Type 1 diabetics, and others, should find the article very interesting...rather startling, too!
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2037674/pdf/brmedj03598-0003.pdf

Monday, September 25, 2017

Type 1 Diabetes Study

I was diagnosed in 1945, and I have been type 1 for 72 years. I do not have diabetes related complications, except for some neuropathy. How is that possible? I don't know. It could be good genes. My last name has Celtic and Welsh origin, and there are many Vaughn's in Ireland. Maybe my good fortune is the luck of the Irish. 
There is a Facebook group called "The Joslin Medalists". It is a secret group. (Shhhh, don't tell anybody!) All the members there have been type 1 for at least 50 years, and they have Joslin 50 year medals. There are more than 5000 people who have been awarded that medal, and a great majority of us do not have any serious diabetes complications. We can't all be Irish, so there must be some other explanation. lol
The Joslin Medalist Study is attempting to find the factors that have enabled us to have type 1 for so long, without serious complications. Dr King, head of the study, in Boston, says there is some kind of special inner protection that many of us have that keeps our eyes, kidneys and nervous systems healthy. Many of you type 1 people here are very likely to have that inner protection, too. Dr. King also said that our hearts do not benefit from that protection, so he advised us to take very good care of our hearts!
Some progress has been made on pinpointing this inner protection. The study, 2005-2017, has thoroughly examined 1020 medalists. I participated in 2009, and again in June of this year. In the days ahead I am going to post some of the results found with this study.

Wednesday, September 13, 2017

Thursday, September 7, 2017

Lilly the Insulin Doll

Have you heard of Lilly, the insulin doll? In the early 1920s the Lilly insulin company supplied free insulin to a group of children being cared for by Dr Elliot Joslin. At Christmas time, the children thanked Mr J K Lilly for the gift of the life saving insulin by sending him a personal letter. Mr Lilly was very touched by the letter, and he sent each child a new doll, and a new insulin kit. Each child named their dolls Lilly. There is a picture below showing Dr Joslin with one of the children.
The doll shown was created to celebrate the 77'th anniversary of the discovery of insulin. I could not find a picture of the original doll sent to the children by Mr Lilly.
There was also a much more recent attempt to have a "Diabetes Barbie" doll created. One of my Facebook friends was successful in getting that done. You can google "Diabetic Barbie" and see the result of that attempt.



Sunday, September 3, 2017

80 Years With Type 1 in the UK

This man received the HG Wells medal for living with type 1 diabetes for 80 years in the UK. "Mr Whittaker, 88, who was diagnosed with type 1 diabetes when he was eight-years-old, was presented with the award by Diabetes UK." He was the first person to receive this medal. H G Wells co-founded the Diabetic Association, now known as Diabetes UK, with Dr Robert Lawrence in 1934.
The Joslin Diabetes Center also awards an 80 year medal in the US. I will be eligible for mine in 2026.

http://diabetestimes.co.uk/8971-2/#sthash.yddNnFEP.dpbs

Tuesday, August 29, 2017

Saturday, August 26, 2017

The Cleveland Bros, Long Lives With Type 1

Type 1 folks who lived to a ripe old age are not so unusual now. Even in the early 1900s, just a few years after insulin was discovered, there were people diagnosed who lived into their 80's and 90's.
Bob Cleveland was diagnosed in 1925 when he was 5, and lived until he was 89.
Bob's brother, Gerald, was diagnosed in 1934 when he was 18, and lived until he was 93.
These brothers really inspire me. I was diagnosed in 1945, when I was 6, and have been type 1 for 71 years. The tools available and the knowledge for diabetes management are so much better now. When I read about people like the Cleveland brothers, it makes me feel I might live to be 100, or more. I need heroes, too. :)

Here is the story of Bob and Gerald Cleveland:
http://www.diabetes.co.uk/blog/2015/06/diabetes-legends-the-cleveland-brothers/

Wednesday, August 23, 2017

Scar Tissue and Site Rotation

When I was diagnosed in 1945 at 6 years old, 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 small 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 1990s 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. All of my doctors had been GP's and they knew very little about diabetes. 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 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 almost twenty years. Finding someone who told me about scar tissue has greatly improved my control. I will never know how 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 hope that my online friends with diabetes do rotate sites, and use different body parts to avoid scar tissue.
The diagram below shows my A1c's, starting in 1980. The higher A1c's at the beginning were partially due to my scar tissue problems.


Tuesday, August 15, 2017

Friday, August 11, 2017

Another great post on ten common diabetes myths. The Diabetic Journey. Thanks to Brittany Gilleland.

Wednesday, August 9, 2017

Born With Diabetes

I have a Facebook friend who lives in the UK, and she was born with diabetes. That is called "neonatal diabetes". She was diagnosed four days after she was born. She weighed 3 pounds at birth, and weighed only two pounds soon after after birth. I was so impressed with her report in the Facebook group called "The Insulin Gang", a UK group. She gave me permission to post her story here.
"I was born with diabetes. My actual type is the rare neonatal
diabetes mellitus, which again can be a factor according to the
consultants. My show off moment is that I made medical history by (1) being born with DM and then (2) surviving past the first few months. Then again 46 years ago was the medical equivalent of the dark ages and the medics didn't think it was possible for someone so young to be diabetic, so they didn't test me for diabetes. Because I was fitting, they decided it was epilepsy and pumped me with more sugar (really helpful that one). In fact I was on my way out when a doctor who was diabetic herself decided she'd come to see the baby who was causing all this bother and it was her who said test me for diabetes. Without her I'm pretty certain I wouldn't be here now. There was a paper written in The Lancet when I was a baby.
I always needed to have a lot less insulin than was "normal". I'm not sure if the medics got to the bottom of this scientifically but it was regularly noted and mentioned. That actually makes sense too, that there's some (if a little) of my own home made insulin going around. Also I have seen a medical report that says too low hba1c is harmful, and there's a range that's just right. Sounds a bit like bears and porridge, too hot, too cold, just right.
My keeping me at that limit good hba1c range is always my goal (and happily I can do that). My reactions aren't normal either, for instance most T1s get really high blood sugars when stressed. If I get too stressed then my blood sugars go too low - that's why I use meditation and mindfulness to help with the stress management, which helps the diabetes. My paediatric diabetic consultant used to do talks about what "most" T1 children did and she used to think "and then there's Louise". I just think that I'm blessed having been born with NNDM because it seems to have helped me, for whatever reason that is. I do also give myself a huge pat on the back for owning my diabetes, working with my diabetes and having it part of me.
It is really nice for folk to actually take notice of my weird and wonderful background. I've had (idiot) doctors say that they don't believe me - I put them straight - why would you make this up! . Thankfully all of my consultants have been good ones."
With online research I found the following information about neonatal diabetes (NDM):
"NDM is a monogenic form of diabetes that occurs in the first 6 months of life. It is a rare condition occurring in only one in 100,000 to 500,000 live births. Infants with NDM do not produce enough insulin, leading to an increase in blood glucose. NDM can be mistaken for the much more common type 1 diabetes, but type 1 diabetes usually occurs later than the first 6 months of life. In about half of those with NDM, the condition is lifelong and is called permanent neonatal diabetes mellitus (PNDM). In the rest of those with NDM, the condition is transient and disappears during infancy but can reappear later in life; this type of NDM is called transient neonatal diabetes mellitus (TNDM). Specific genes that can cause NDM have been identified.
Symptoms of neonatal diabetes (NDM) include thirst, frequent urination, and dehydration. NDM can be diagnosed by finding elevated levels of glucose in blood or urine. In severe cases, the deficiency of insulin may cause the body to produce an excess of acid, resulting in a potentially life-threatening condition called ketoacidosis. Most fetuses with NDM do not grow well in the womb and newborns are much smaller than those of the same gestational age, a condition called intrauterine growth restriction. After birth, some infants fail to gain weight and grow as rapidly as other infants of the same age and sex. Appropriate therapy improves and may normalize growth and development."

Wednesday, August 2, 2017

Retirement and Living With Diabetes

I was employed as a teacher at the college level for 34 years (1963-1997). I had complications with my diabetes, and had to retire several years earlier than I had planned. Two years after retirement my health problem was resolved. I was diagnosed with insulin resistance, and I started taking an oral medication to help with that. My former position at the college was filled, and I was no longer needed as a full-time teacher. After retirement I taught part-time for several years, and did a lot of carpentry work and painting on my home. My strength was gradually declining, and I had too little energy for strenuous activities. I felt like a fish out of water, and was very bored much of the time. Retirement did not seem to be as great as I thought it would be.
As a teacher I did not earn a lot of money, but the fringe benefits were very good. My wife and I financed our two sons while they were in college, until they had MS degrees. We were heavily in debt by the time they graduated. Gradually we paid off our debts, and our financial situation was stable. There was too little money for traveling like I had always wanted to do. My wife did not want to travel, she was perfectly happy staying at home, and taking one trip each year to see our sons and our two grand children. I wanted to do so much more, but we could not afford it.
In 2006 I discovered a diabetes support group online at Dlife.com. The support group there was a new found hobby for me. I soon joined other diabetes websites, and made many friends. Sharing my diabetes experiences with others was very rewarding. I helped my new friends, and they helped me. I was the only long term type 1 diabetic in most of the support groups, with more than 60 years of diabetes. My friends encouraged me to write a book about my life with type 1. That book was published in March, 2010. I was pleased with the hours I spent each day with my friends. I joined Facebook in late 2010, and found many more diabetes support groups. The parents of diabetic children were encouraged to find a long term type 1 diabetic who had good diabetes health. In July, 2013, I attended the Friends For Life Conference in Orlando, FL. It was a wonderful experience. So many great discussions, pictures taken with friends, and good food. My wife went with me to the FFL in 2015. I was a speaker that year, and I want to do that again.
More recently, health problems began to emerge. My wife needed a knee replacement in 2009, and in 2013 I had one of my knees replaced. My wife and I have arthritis, which slows us down, and makes many activities difficult. We don't know how much longer we can make those flights to Atlanta to visit our children. Our sons are very busy with their jobs, and they find it difficult to visit us each year. We live in New York, so we are are not physically able to pack up all our belongings and move south to Atlanta.
Without the online activity and communicating with my friends, life would have become incredibly boring. With my good health, working out at the gym, taking long walks, and my online activities, I am very content. I also do a lot of projects keeping our home in good shape. My wife is very happy tending her flower gardens, spending time with her hobbies, and communicating with the neighbors. We have been married 53 years. Now, after 71 years of type 1 and at age 77, my diabetes health is still good. Retirement is good, for both of us!!

How I Deal With Low Blood Sugar

When my BG drops slowly, my body has time to adjust, and I don't feel the lows until I am below 50. When I drop fast, my body does not have time to adjust, so I feel the low in the 70's, and sometimes in the low 80's. When I treat, I see how many points I need to reach 100. I divide that number by 3 since that is how much my BG will typically rise for each carb I eat. If I have insulin on board from a previous bolus, I take that into account. Then I know how many fast acting carbs I need. I am so used to doing this that I can determine the number of carbs I need very quickly. The result may not work exactly as planned, but it rarely results in a very high BG after treating. This routine is much better for me than "eating the whole contents of the fridge" like some people say they do, lol. Some people say they go to the kitchen during a low, and that will sometimes involve going downstairs. I have even heard people having a low that is so bad that they have to crawl to the kitchen. Why do people do that? Please keep some fast acting carbs with you at all times, especially within easy reach at night. Glucose tabs, jelly beans, etc. I have a zip-lock bag of jelly beans or Skittles in my pants pocket when away from home, and I always have glucose tabs or fast acting candy within reach when at home.
I am using a Dexcom G4 CGM now. I can see oncoming lows, and eat some fast acting carbs before I have a hypo. That is so much better than having a hypo, and treating before my BG goes dangerously low.

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: