What Can People with Type 1 Diabetes for 50+ Years Teach Us?
What Can People With Type I for 50+ Years Teach My Child?
I went to a research briefing by Ronald Kahn, MD, the head of the Joslin Center at Harvard. The Joslin is one of the premier research and treatment institutions in the world for both type 1 and type 2 diabetes. Dr. Kahn told us about the Joslin’s study of people they call “50 Year Medalists” – men and women who have lived with diabetes for more than 50 years, some as many as 75 years. This means they were diagnosed anywhere from 1920 to the 1950s, in the early days of insulin. They checked their urine, not their blood, and used glass syringes with stainless steel needles that had to be boiled and sharpened. Imagine how much more difficult their diabetes treatment was in those days, and yet they have survived. There are now about 2,500 “medalists,” and here’s what we know about them:
• Nearly half of them, or 47 percent, report that they have no complications from the disease; Of those …
• None reported using tobacco;
• None reported complications with pregnancies;
• There is a greater degree of physical activity among those who report having no complications than among those who do, although Dr. Kahn said that it seems everyone in this group “lives life to the fullest.”
What is most surprising about this group is that approximately 20 percent of the 50 year medalists still produce insulin in their pancreases. Even though they have type 1, their islet cells are still struggling to produce insulin despite the immune response. This is of great interest to George King, the Joslin scientist who studies the medalists to learn what had can for the sake of our children. Dr. King has designed a study to answer the following questions:
• What biological and genetic factors differentiate the medalists from others who have Type I?
• What makes their extended survival possible?
• What new targets can we design for therapies for the complications?
How do we prevent complications in children with type 1 – what did these people do right?
One thing we do know: research shows that children who learn to manage well early do much better in terms of complications. The landmark DCCT study showed that tight control leads to reduced complications. Clearly, these medalists have kept their blood sugar numbers in tight control and reduced their complications – or at least 47 percent of them have. I don’t wish for any more medalists – I want diabetes to be cured well before my daughter is eligible to join the group – but I am glad for them. We can all learn a lot from them.
Published On: April 28, 2006