April 19, 2013

What do the Joslin “50 – Year Medalists” have in Common?

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50-Year_T1DA significant number of diabetic patients, known as the Joslin 50-Year Medalists, remain free from various complications such as nephropathy and proliferative retinopathy after 50 years or more of diabetes.

The Joslin Diabetes Center’s 50-Year Medal Study found similarities in members in this elite club. The factors had to do with: family, lifestyle, clinical results, and complications or lack thereof.

Who would have thought that your parents age of death had anything to do with your success rate of life with diabetes? Apparently many of the 50-Year Medalists have parents who lived into their 80s. Good genes never hurt anybody, especially people with T1D.

Do your beta cells work? If you want to be one of the 50-Year Medalists, you’re a contender. In fact, over 66% of people appear to still produce some insulin. This means that their c-peptide levels are measurable.

To those of us living with T1D today, we owe utmost respect to the Medalists who’ve generously donated their organs to science. One thing we know is that 100% of deceased Medalists who donated organs to science  have c-peptide.  These are also the Medalists who appear to have escaped serious complications, which occur more often in Medalists of today.

Another reason why the evasive c-peptide may be more important than we think: HbA1c doesn’t correlate with the various complications described above.  Without question, insulin regulates glucose metabolism. But the findings published Diabetes Care in 2007 indicate the microvascular complications are prevented with a horse of a different color.

In lay terms, insulin is like the fuel in you car. It keeps the car moving. C-peptide is like the oil in your car. It keeps the parts working.  For a car to last, you need fuel and oil for your car. Maybe your body needs insulin and c-peptide?

Furthermore, of the T1D 50-year Medalists, weight, high good cholesterol levels and relatively low body weight are commonalities. About 40% of the Medalists do not have serious eye disease even after 50-80 years of T1D and less than 10% of the Medalists have any kidney problems.

These folks have an uplifting outlook on life and they exercise regularly. Whether it’s cycling, jogging, or ballroom dancing, it’s essential to elevate your heart rate and your head.

The introduction of synthetic human insulin (analogues) was 1983. Human analogues are designed to be just like human insulin. A study from Barbara Davis Center for Childhood Diabetes indicates that insulin may be what sets-off the autoimmune attack in T1D.

People diagnosed with T1D 50 years ago were treated with natural pig or cow insulin. These insulins were slightly different than synthetic human insulin. Could this have lessened the attack on beta cells and protected the insulin-producing cells (i..e. c-peptide)?

I wonder what the rate of Medalists with complications will be beyond  2033. So far, it’s looking pretty good. Those of us diagnosed circa 1985. are hangin’ in there. To infinity and beyond….

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