How long have you had diabetes?

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Permalink Reply by Scott Strumello on March 30, 2008 at 10:16am

Bill and others,

This is my 32nd year, so I've been through a lot of what you all describe, although knock-on-wood, no disease related complications other than hypoglycemia unawareness, and there's a mountain of evidence suggesting that synthetic insulin (made via recombinant DNA technology) is to blame for that. Porcine insulin is still available for sale from Canadian pharmacies, so there is an alternative if you wish to try it.

I already posted something related to hypoglycemia unawareness on another thread you might find worth reading. Your CDE is not being completely forthcoming with you, as hypoglycemia unawareness is a bit more complex than simply avoiding lows. While symptoms may "restore" themselves, they may not -- so while I recommend trying, don't beat yourself up if the solution doesn't work! Avoiding lows does not guarantee a restoration of symptoms!

Hypoglycemia unawareness is more appropriately described as being the result of the interplay of insulin excess and impaired glucose counterregulation. What does that mean?

To understand this issue, you must understand a few basics. First, the basic difference between type 1 and type 2 is relevant here, because as you probably know, type 1 is caused when the body's immune system mistakenly attacks (and ultimately destroys) the pancreatic beta cells (which make insulin and amylin). While the inflammation ultimately destroys the beta cells, all of the cells found in the Islets of Langerhans are impacted, therefore the alpha cells which produce glucagon are also damaged and can therefore no longer properly respond when glucose levels start to fall (this is not the case in type 2 diabetes, as even when the beta cells ultimately fail and the patients require insulin, virtually all still have a fully-functional counterregulatory response). That's strike one.

Next, in patients with type 1 diabetes, as glucose levels decline, insulin levels do not decrease – they are simply a passive reflection of the injected insulin, which is strike two. As a result, the body's first two defenses against hypoglycemia are lost. The one remaining defense is the epinephrine (sometimes called adrenaline) response, and unfortunately, that is also impaired.

Sometimes, lows can reduce this response even more, which is why many people tend to mistakenly blame the patient for hypo unawareness. It is true that the reduced glucose threshold for the epinephrine response is shifted to even lower glucose levels following a hypo, but it is factually inaccurate for anyone to claim that avoiding lows will "restore " the symptoms of a low, rather it may help shift the level a bit higher (therefore you get symptoms sooner), but the epinephrine response will still be reduced.

While the "symptoms" of hypoglycemia can be characteristic, particularly for the experienced individual with diabetes, the symptoms and signs of hypoglycemia are nonspecific, and may vary with each occurrence. Symptoms of hypoglycemia are idiosyncratic and may also be unique to a given individual. Thus, many people with diabetes learn their unique symptoms based on their experience.

I would add that symptoms of hypoglycemia may occur but not be recognized as indicative of hypoglycemia, particularly when your attention is focused on other issues. For example, a large number of patients report that they are less likely to recognize hypoglycemia while at work than during leisure activities.

My personal recommendation is that if it does not work, ask your CDE about Blood Glucose Awareness Training (BGAT) which was developed by the University of Virginia Diabetes Research Team in Behavioral Medicine. A good CDE should be aware of it, if they aren't, print the Diabetes Care article (its available as a pdf document) and bring

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Permalink Reply by Frank Kolakowski on May 12, 2008 at 12:04pm

WOW! I might be the 2nd oldest man in the group. Olaf is pretty impressive at 64 years. I have read that the very first girl treated with insulin died in her 70s. I have been diabetic since October 1966, 41.5+ years.

I have a few issues (retinopathy, diabetic frozen shoulder, but generally pretty good. I have done a lot of backpacking and camping and been all over for my job.

I have used a whole bunch of different regimins -
bovine regular and bovine zinc insulin (pre NPH) glass syringes, and Clinitest tablets that get dropped in to urine in a test tube for bg testing. Now I have a Minimed 522 pump (my second) and Realtime CGMS blood glucose sensor. What a change.

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Permalink Reply by Karen Vecchitto on May 13, 2008 at 9:24pm

27 years this month. I was 10 years old when I was diagnosed.

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Permalink Reply by mary ann jacob on May 16, 2008 at 1:06pm

Hi Kayla; I have been a type 1 diabetic for 38 years I got it when I was 15 yrs. old. So far no major complications except a little digestion problems and also hypoglycemia unawareness. I thank the Lord for His protection on mee I also am the mother of 2 children so it is important to stay healthy as possible!

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Permalink Reply by Molly on May 23, 2008 at 7:38pm

In August, I will have had diabetes for 33 years.
I have hypoglycemia unawareness, but no other complications.

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Permalink Reply by Sam Innocent on June 2, 2008 at 6:26am

29 years with no complications. I'm still on twice a day shots using syringes (so pretty old skool, so to speak!!) with porcine insulin - it works for me though!

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Permalink Reply by Doris Ann Dickerson on June 2, 2008 at 8:25am

I've had it for 34 or is it 35 years now a few problems but over all doing ok. My oldest has had it for 8 going on nine years and has just had her 2nd daughter! She has no problems so far!!!!

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Permalink Reply by Mick on June 5, 2008 at 11:09am

30 years this November.

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Permalink Reply by Mia on June 8, 2008 at 7:41pm

June 1985, that makes it 23 years. I have no complications with my diabetes and do well with diet and an active lifestyle (2 dogs and eliptical machine). I have trained myself to watch portions and count carbs making my control pretty good (last A1C 6.4) but would like to see it come down to a 6 or lower. I am now using the pump for 2 months and enjoying the freedom and flexibility.

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Permalink Reply by Bernard on June 10, 2008 at 5:38am

I was diagnosed in Ireland on September 10, 1972. This September it will be 36 years for me.

I'm using a Cozmo pump and a Dexcom CGM to manage my diabetes.

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Permalink Reply by Ewa on June 13, 2008 at 5:20am

I've had diabetes for 25 years. I was diagnosed as a small kid. And I have a some problems with my eyes, but after laser therapy is ok:)

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Permalink Reply by Sherry on June 18, 2008 at 9:45pm

I was diagnosed in October 84, so it will be 24 years in a few months No complications so far...I am proud to say I have ran 2 marathons and am getting ready to start training for my third. I am on MDI but considering the pump.

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