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 blood 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 many 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 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.
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.
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, cataracts, and some mild spots of neuropathy occurred during that time. Several years later I was diagnosed with neuropathy in my feet. All of these things occurred after I stopped the animal insulins, and started using the synthetic insulins that are still used at the present time. How can this be? We know so much more about diabetes now, and we have devices, 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?
There are doctors who have told their diabetes patients that if they can avoid complications during their first 20 years with diabetes, then they are not likely to have complications later on. My complications began about 50 years after my diagnosis, so am I an exception to the rule? I really cannot fully agree with that 20 years rule.
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. Some of them have been diabetics for 10 or more years longer than me, and they do not have any serious problems that are diabetes related.
There is a study taking place at the Joslin Diabetes Center, in Boston. It began in 2005, and is ongoing at the present time. 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 2012, I have no symptoms of any complications that really bother me. Some mild arthritis, some dizziness in the mornings, and occasional symptoms of neuropathy are all that are present now. I am so fortunate to be doing so well, but I will always be curious about how it has all evolved.
This is the most recent blog from my blogsite:
Hi MegaMinx, I never took multiple shots of regular. I was on one shot per day of various beef/pork insulins for many many years. My NPH+R started about the same time as yours. My doctor would not approve of my pumping because I already had good A1c's. He said it would cause me to have too many really bad hypos. I went to another doctor (my first endo) in 2007 and started pumping that year. I have not needed assistance with a low since my first month of pumping.
Hi Richard. I never used multiple shots of regular insulin. I was started on one shot of NPH and like you started one shot of NPH + regular around the same time as you. I always felt that another shot of Regular would be good at night for me but had experienced too many lows in the middle of the night. There was no "fine tuning" of the insulin with the pumping of today. I too have been on the pump for a few years and I also find the Minimed CGM system great. Although not always accurate the very helpful thing I find is that I can see which direction my blood sugars are going. I am constantly amazed at how quickly BG can change. I was always under the mis-conception that BG's stayed steady at a certain number......I never seem to "flat-line" with the CGM. I always try explaining to those close to me that with the consistend up and down of my numbers how do they expect me to be "in a normal mood all the time" - that's a whole 'nother discussion.
Sheila, I agree with you in regards to our mood changes. It's difficult for people who don't go through the changes we do to understand. For many years I didn't understand what was happening until I got more information regarding Diabetes...and that was only about 15 years ago.
My mood changes for all kins of reasons. The trouble with that is my wife thinks any time it changes, I should test and see if I am high, or low.
Sometimes my husband thinks the same thoughts but most times I test on my own. Especially when I feel agistated or very moody and want to scream or cry.
I always thought that it is harder having D if you are a woman, with all the hormonal changes we go through, every month, plus menopause ! I just thought I was a naturally moody person . I agree with Richard - my husband is always telling me to check my sugars.
I always said I am a very hard person to live with. My children just thought I was "crazy"..!!
For those of us who have lived longer then predicted those many years ago have been fortunate. I've lived 53 years with this disease but experienced somewhat earlier complications. In the 1980s I experieced Neuropathy while still on animal insulin. Only when I learned in the 1990s how to control this disease was I able to get a grip on what Diabetes was all about. We were diagnosed in the dark ages of Diabetes and heavan only knows how we survived.
Joslin's study might eventually bring to the light why some of us survive and why we do. I also experienced some other complications in the 1980s like Retinapathy (sp?) for which I was fortunate to have laser treatments for. I don't have heart problems but do have kidney disease which was diagnosed in the 1990s. I don't believe that complications can be avoided but delayed with the education that should go along with diagnosis. We were not as fortunate as those who are diagnosed today, they have much more resources and information then we did.
When I compare the insulin of years ago to today's I prefer today's insulin. Although I'm now pumping and have been for many years compared to MIDI with animal insulin I prefer today. I too take more meds then years ago but I'm now older then years ago and so are you lol. Anyway Richard you have done well and keep up whatever you're doing to stay well....stay well as you can.
I am also from the diabetes dark ages (diagnosed in 1958). The only diabetes related condition I had in the first 5 yrs after diagnosis was skin lesions that I later found out are called necrobiosis lipodica. By the 80's after changing to biosynthetic insulin (human insulin then analogs) I had some mild neuropathy. Now the main complications are those associated with old age -- high blood pressure, cataracts, mild hearing loss. Something has protected me from more severe complications. One wonders if the contaminants like c-peptide in the animal insulin may have given some protection. Also, for a number of years I used u-80 strength insulin which may have been easier to dose when using smaller numbers of units.
There was a mouse study done in Brittan about 7 0r 8 years ago. They had 2 groups of diabetic mice. One got insulin the other got insulin and equal doses of C-peptide. The mice that got C- peptide had NO complications at all, where of the insulin only mice 35% had some complications.
I don't know if that has ever been trialed on people. I often thought that C-peptide had some function, it was always referred to as a byproduct of insulin production when I took biology. It think it does something to prevent those complications.
My theory why type 2 people get complications is that type 2s are insulin resistant and possibly C-peptide resistant too.
If it were available, I would take it. It is naturally occurring I don't think it could hurt.
Thanks for that report, Tim. Very interesting!
There is a company in California that has developed an injection for giving C-peptide, but it is not available to the general public. They have been working on the project for several years, and it has proved successful with human subjects.
Hi Richard 157, that's an interesting theory you have regarding beef/pork insulin. I've been Type 1 for close to 30 years and I got on the tail end of beef/pork inuslin, but was switched to the Human/synthetic insulins maybe a couple of years after diagnosis. I know up until the last year or so I have NO had good control. Kinda did what I wanted to do, but I too have remained complication free. I do have some neuropathy in my left foot, BUT it's not D related, its from injuries from a car accident years ago. I did just this last year have a bad case of cellulitis from a little cut on my toe. But no kidney, eye, cholesterol, blood pressure issues at all. Overall Im very healthy.
I'm pleased to hear about your good health, Christy. I have some mild neuropathy too, and I never have symptoms except in my left foot, like you. Mi neuropathy is due to diabetes, but it rarely bothers me.