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From Connecticut, USA:

My husband has been a Type 1 diabetic for the past 30 years. He has been monitoring his blood sugars along with an exercise regime that includes running and weightlifting. We try to keep his blood sugars between 80 and 170. He has had several insulin reactions and we continue to lower his insulin intake (with doctor's approval). He is now down to only 4R and 4NPH in the morning and 1 or 2 units of R at night. He has had no other health complications due to his diabetes. It seems that every year, he is taking less and less insulin.

Does age, exercise and length of time someone has been a Type 1 diabetic have any long term impact on insulin level requirements?

What is the longest length of time any one individual has been taking insulin injections with no complications?


Your husband would now appear to be taking less than 0.1Units/Kg. body weight/day which is a very small dose indeed. 30 years ago it is easy to understand why he would have been diagnosed as Type 1 Diabetes. In a very few of these cases the autoimmune process does seem to burn out and leave some residual insulin response but it is very unlikely that this would go on so long.

What I think is more likely is that your husband has one of a number of different genetic conditions going under the rubric of Maturity Onset Diabetes in the Young. Most probably he could be a spontaneous case of one of the glucokinase deficiencies. This is an enzyme that affects the energy available for insulin production. The amount of insulin made is usually somewhat less than is normally required; but it responds normally to glucose. The years of supplementing insulin will not have done any harm and may indeed have preserved endogenous insulin production. Actually confirming such a diagnosis could be a rather elaborate affair; but in view of the present very low dose of insulin and what seems to be excellent control you might like to talk to your doctor about trying a new drug called troglitazone [Rezulin® brand] which has just become be available in the USA. What it does is increase the sensitivity of insulin receptors so that smaller amounts of insulin are required for normal function. Control might not be all that better; but it might be a relief to do without injections.

[Editor's comment: I'm not sure of the record duration of complication-free diabetes is, but Joslin Clinic (in Boston) has handed out a whole bunch of 50-year medals. And a few years back, I had a delightful 69-year-old lady as a patient; she had no retinal disease despite 64 years of Type 1 diabetes (For all I know, she might still be going strong!). WWQ]


Original posting 16 Mar 97


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Last Updated: Tuesday April 06, 2010 15:08:54
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