Monday, April 10, 2017

My Diabetes Now vs My Early Years

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

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