Friday, June 21, 2019

Wednesday, June 19, 2019

Diabetes and College, 1957-59

Diabetes and College, 1957-59

My parents told me I could not go to college. They thought I would not be successful because of my diabetes. None of my relatives had ever gone to college. Many of them had good jobs and good salaries They lived in fine homes. My parents did not understand my being so obsessed with going to college. What they did not understand was that I was deeply hurt by their telling me I would not make it through college because of my diabetes. I wanted to show them I could do that, and do it well! I had a good mind, and I wanted to use it in a meaningful way.

They begged me to apply for a job at the post office where my father worked. I could become a post office clerk, and he could watch over me. So I had to choose between standing at a counter selling stamps and weighing packages, or going to college. The only coed college available was Roanoke College, just 20 minutes away. If there had not been a college nearby I would never have gone to college. My parents were disappointed in me, and Mother cried. They were so dead set against my doing this.They refused to pay for any part of my tuition or my college expenses. They were kind though, and they gave me free room and board. Daddy let me drive his older Chevy instead of trading it in when he bought a new car. He kept the car in good shape, and paid for the gas. I had no money of my own, so I had to get a job. I started working at a supermarket the very month I graduated from high school. I worked about 30 hours per week during the summer, and started off at 75 cents per hour. Every few months I would get a raise of 5 or 10 cents per hour. I saved enough to pay for half of my tuition for the fall semester. I was supposed to pay the other half later during that semester. College expenses were so much more reasonable back then. If someone was working at a grocery store to pay for tuition in the 21'st century, it would be impossible. My being able to live at home, and make enough money to pay tuitions, made it possible for me to go to college. I reduced my hours at the grocery store when college was in session.

I wanted to become an architect. There was a pre-engineering program at Roanoke College, and I chose courses that would enable me to transfer after two years to Va. Tech, to become an architect. I made all A's and B's (mostly A's) during my freshman year, except for chemistry. I was not ready for college chemistry. I talked to the chemistry teacher and she understood my problem, but she could not do anything for me. I received C's in both semesters of chemistry, but I knew almost nothing about chemistry when the spring semester ended. Not having had the high school prerequisite chem course made it almost impossible for me. I felt the C grades were a gift. I was very grateful, but I felt guilty about it. I made new friends while in college, and we visited each other's homes. We played golf and went bowling many times. Good friends. I had a crush on several girls while in high school, and during my freshman year of college, but I was too shy to ask them for dates. I had my first date during my sophomore year of college. My shyness and lack of confidence kept me from dating until then.

While in college, I continued with one shot of animal insulin each day. I had Test Tape for testing my urine. That was so much better than the test tube and boiling on a stove. There were no glucose tablets for a long time to come. Sugar worked very well. I remember having lows during tests, and my teachers never let me take a make-up test. I took my test with my class, or not at all. I had a low during a calculus test that was so bad that my vision was blurred, and I could not read my test paper. My teacher would not believe me. That was the only math test I failed in college. There were only three tests and a comprehensive final exam in each math course I took. My failing grade on that test resulted in a B grade for first semester calculus. I made A's on all of my other Calculus tests.

When I returned to campus for my Sophomore year the pre-engineering program had been cancelled. I had engineering drawing, engineering orientation, and a class in slide rule during my Freshman year. (Can you believe that? There were no computers back then, and slide rules were very popular. I carried it strapped to my belt for my Freshman year. I still have my slide rule in a closet today.)

Since the pre-engineering program was cancelled, I could not continue my preparation to become an architect. It was too expensive for me to commute to Va.Tech, even though the campus was only one hour away. I needed to stay in Roanoke and work at the grocery store so I could continue paying my tuitions at Roanoke College. I had to change my major, and give up the idea of becoming an architect. I had always loved math in high school, and during my first year in college. The head of the math department convinced me to change my major to mathematics. I was disappointed that I could not continue to prepare for becoming an architect, but it all turned out well. The wonderful things that happened in the years ahead would not have happened if I had continued my original major on another campus. My mother was pleased that I would continue for four years at Roanoke College, while living at home.

I dated a very nice girl named Linda during my Sophomore year. We dated many times, and I really liked her. I will continue with that in my next chapter.

Saturday, June 15, 2019

School and Type 1....1945-1957

One shot per day, one urine test, large portions of food, and no worries. We did not know there was any potential problem, and I led a rather normal day to day existence. Ignorance was bliss!! There were no health problems with my diabetes throughout my childhood, despite my very irregular blood sugars. I have often wondered why I did not have DKA back then. Was something protecting me? All the fast acting carbs I ate each day, without correction boluses like I take now, must have kept my blood sugar very high. The only times I had lows and hypos were when I got too much exercise, and sometimes during the night. My insulin was working during the night just like it did during the day, but without food. That would sometimes give me lows and seizures while I was sleeping, if I did not eat enough before bedtime.
My parents did the best they could for me during my childhood. Dr. Davis gave no instructions that helped. My parents raised me in much the same way that they were raised in their mountain homes. They did not drink, smoke or swear. They were good Christians, and kept to themselves. They bought land outside the Roanoke, Va. city limits so they could have a farm. They were raised on farms, and they loved that kind of living. That had a lot to do with the way I grew up, the development of my shyness, and my overall personality.
My mother wrote her own story when she was in her 80's. She only briefly mentioned my diabetes diagnosis. She did not say anything about the months leading up to my diagnosis, or the trauma in the months that followed. My parents were devastated by my diabetes, and not knowing how to care for me. The memories were probably too painful for her, and she chose not to include those details in her story. It is impossible for me to remember all that happened back then, but my parents told me all the details years later.
I was not a very good student during my first few years of elementary school. I made a lot of C's but I never failed a grade. I studied hard,and my Mother was a great help. She was a good tutor. I had hypos during the night about once per week, and then ran high blood sugar during the day. All those carbs caused the highs. Mother was afraid I would have a hypo while at school. She approached the teacher at the beginning of each year and explained my condition. She said I should not exercise like the other kids. She convinced Dr. Davis to write an excuse before school started each fall. I never participated in play period or gymnastics of any kind. I sat and watched the other kids. Mother would not have it any other way. My classmates knew I was different, and they ignored me but never made fun of me. I tried to make friends, but I was never very successful. I became very withdrawn, and terribly shy. I hated my diabetes, and blamed it for my misery in school. I never blamed my Mother because I also feared having a hypo in school. Mother always brought me out of my hypos at night by feeding me water containing a lot of sugar. I knew there would not be anyone to do that for me at school, so I sat and watched the kids play, and felt comfort in knowing I would not have a hypo. I would have been so embarrassed if I had had a hypo at school. I never did have a hypo in grades 1-12.
By the time I reached fourth grade I started making better grades. In the sixth and seventh grades I made several A 's and B's, not many C's. I was always the best in my class at spelling. I took great pride in my ability to spell complicated words. When I reached high school my Mother still wanted me be excused from gym classes. I was rather good at basketball, at home. Daddy nailed a barrel hoop to the side of the corn crib, and I became very good at making baskets. I played and worked hard at home, but always under Mother's watchful eyes. I still had that fear of having hypos in high school, so I agreed to not participate in gym classes. I wish now that I had rebelled and taken gym. I was still withdrawn and shy in high school. I made a few friends though and my grades were very good. I graduated number 13 in high school in June, 1957. My math teacher in my senior year found that I was not intending to go to college. She begged me to go. I considered it but I knew my parents would not approve.
My parents told me I could not go to college. They thought I would not be successful because of my diabetes. None of my relatives had ever gone to college. Many of them had good jobs and good salaries They lived in nice homes. My parents did not understand my being so obsessed with going to college. What they did not understand was that I was deeply hurt by their telling me I would not make it through college because of my diabetes. I had to show them I could do that, and do it well!
The picture below is my senior year picture in high school.

Sunday, June 9, 2019

Misdiagnosis of Adult Diabetics

I have read so many times about adults being diagnosed with T2D when they are actually have T1D. Here is a quote from a very good article on this topic.

"People with adult-onset Type 1 diabetes/LADA who are misdiagnosed as having Type 2 diabetes are wrongly treated as though they have Type 2 diabetes.  Consistent evidence shows the importance, in terms of clinical outcome, of early initiation of insulin therapy in Type 1/LADA.  Thus, the early clinical recognition of people with adult-onset Type 1 diabetes, as distinct from Type 2 diabetes, is extremely important to guarantee the most suitable treatment in order to preserve beta-cell function, gain optimal metabolic control, and improve long-term outcomes.  A correct diabetes diagnosis is the cornerstone of correct therapy and a wrong diagnosis delays achievement of optimal metabolic control, frustrates patents, and increases the risk of life-changing or fatal complications."

The link for the complete article appears below:

Saturday, June 8, 2019

Friday, June 7, 2019

A1C Testing

A1c testing was not available until 1976. My doctor started A1c's with his patients in 1980. I was diagnosed in 1945 when I was 6, and I must have had very high blood sugar until about 1988. That was when I learned that carbs had an effect on blood sugar levels. My A1c's began improving. Now I am alive after 73 years of type 1, and I have no complications except for some mild nerve damage.
As part of my preparation for my taking part in the Joslin Medalist Study in 2009, I was supposed to have a listing of all my A1c's. My doctor was very cooperative, but there are several gaps in the list.The years 1990-1994 were not available. Below are the A1c's that my doc was able to retrieve from his files. I have updated for 2013-2016.
1980...10.6, 9.6, 9.0
1984...9.2, 9.7, 8.9
1987...8.0, 9.8, 10.3
1988...10.5, 7.7, 7.7
1997...6.0, 5.4
1999...6.8, 6.7, 6.5
2000...6.3, 6.1, 5.5
2001...5.8, 6.0, 5.6, 6.0
2002...6.0, 6.4, 6.2, 6.0
2003...5.6, 5.4, 5.9
2004...5.9, 5.7, 5.8, 5.6
2005...5.6, 5.8
2006...5.6, 5.7
2007...5.5, 5.6, 5.7, 6.1
2008...5.7, 5.9, 5.7, 5.6
2009...5.6, 5.8, 5.8
2010...5.7, 5.6, 5.6, 5.4
2011...5.6, 5.7, 5.8, 5.6
2012...6.1, 6.1, 6.0
2013...5.8, 6.1
2014...5.7, 5.6, 5.8
2016...5.9, 6.0, 6.1
Notice the drop from the 10's to the 7's in early 1988. That is when I read an article in a magazine that said diabetics should follow a low carb diet. My doctors never told me that. Then in the late 1990s I was permitted to use basal/bolus control. In 2007 I started pumping. My A1c's have been very good during the new century because I finally knew what to do to get good control. I was very successful for several years before pumping too, but using an insulin pump has made good control so much easier.
I took only one injection of beef/pork insulin per day during my first 35+ years. Can you imagine what my A1c's would have been during those years? Those were the years before my doctor started having my A1c's done.
I feel so lucky to be alive and healthy, without serious complications. Is it good genes? The Joslin Study of long term type 1's in the US has reported that many of the participants are still producing some insulin. Those individuals are insulin dependant, but any amount of insulin produced in our bodies is very beneficial in helping to prevent complications. My C-peptide is less than 0.1, so I am producing almost zero insulin. There has to be some other explanation for those of us living so many years with type 1, and not having any serious complications.

Tuesday, June 4, 2019

Joslin 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.
The Joslin medals are available all over the world. People in many countries have the 50 year Joslin medal.
It is necessary to prove that you have been T1 for 50 years when you apply for the Joslin medal. Verification from a hospital or a doctor is ideal, but some people do not have that information. I was told by a medalist that you can have 2 or 3 people who knew you the year you were diagnosed to write letters about what they remember from that year. Those letters are usually accepted as sufficient proof. My sister and a cousin wrote letters for me, and i received my 50 year medal with their help.
Here is the link for applying for these medals. A printable form of the application appears on the link page.

Monday, June 3, 2019

Needles and Syringes, 1940's-1960's

Needles and Syringes,1940's-1960's
My father started giving me shots of insulin in 1945, when I was 6. When the needles were dull, he sharpened them with a "whet rock". We had our own well, and there were lime deposits from the rocks underground. The needles would be coated with these deposits after they were boiled, and they would occasionally become clogged. The opening in the needles was wide enough that we could push a very small wire through and unclog them. When the needles and glass syringe were being sterilized in boiling water on top of our kitchen stove, we would sometimes forget about them, and all the water would evaporate. Then there was a loud pop and pieces of glass would fly all over the kitchen. I don't think we ever got hurt by these flying pieces of glass, but it was a potential danger. Fortunately, we always kept a spare syringe on hand.
One of the pictures below shows a comparison of an approximately 3/4 inch long 26 gauge needle attached to a glass insulin syringe, and a 5mm 32 gauge (5/32 inch) pen needle attached to a Lilly Luxura pen. What a contrast when we compare the 1940's and the present day! I used the 3/4 inch needle during my early years. My doctor had my father inject into my leg or arm muscles at a 90 degree angle. I was "skin and bones" when diagnosed, so the injections were very painful. It was not necessary to push the entire 3/4 inch needle into my muscle. Since I was so skinny, the long needle might have struck bone. Most of the needle was needed in the flesh to get the necessary absorption. Injecting into the muscle caused the animal insulin to be absorbed more quickly. The insulin from pigs and cows was not as fast acting as the fast acting insulins we have today, so having a faster absorption was helpful. In my early years I had only one injection per day, before breakfast. The animal insulin was a 24 hour insulin.
In 1955 there was concern about the infections caused by the use of animal insulin in glass syringes, and the first plastic disposable syringe called the Monoject, was introduced. Unfortunately, doctors thought it was safer to reuse glass syringes after sterilizing them. In 1956 the plastic disposable syringe we use today was designed. Becton Dickinson did "extensive development trials and tests and in 1961 introduced its first plastic disposable syringe, the BD Plastipak."
I was still using glass syringes and long needles from 1945 until the 1960's when disposable needles and plastic syringes became available. There are so many things about my diabetes past that I took for granted back then. I tell recently diagnosed diabetics about my past, and some of them look at me in horror and disbelief.
I remember these things like they were in a movie, and then it dawns on me that I actually experienced all this long ago. I did not have any diabetes related complications from the time of my diagnosis in 1945 until the mid 1990's when I stopped using animal insulin, and started using synthetic insulin....Humalog. Soon after starting Humalog I started having complications. But that is another story, for another day. None of my complications are serious, and I am very lucky to have good diabetes health after 73 years of Type 1 diabetes.
If you have not seen a history of insulin, here is an article giving the highlights.