Living Long and Healthy with Diabetes - Part 1

Joslin medalists share their stories of lives fully lived

By Daniel Trecroci

The First of a Two-Part Series

In an effort to recognize people who have lived with insulin-dependent diabetes for 25, 50 or 75 years, Joslin Diabetes Center in Boston started its Medal Program to commemorate “dedication to lifelong diabetes management.”

We caught up with four people who are recipients of the 50-year medal. They share with us their then-and-now stories about living with diabetes, and offer tips for living a long, healthy life. In this installment, we feature the stories of Patricia Youell and Don Ray.

Patricia Youell

Type 1 since 1934—yes, that’s 73 years of taking insulin—Patricia Youell is only two years away from being eligible for the 75-year medal (which has only been awarded to a handful of people). Residing in Lacey, Washington, Youell was diagnosed at the age of seven and credits her mother with caring for her when not a lot was known about diabetes—even by health care professionals.

Youell recollects that taking insulin in 1934 involved boiling the syringes after each use to get them ready for the next time. She usually gave herself two to three injections per day, and used animal-derived insulin, which is no longer available. Today she wears an insulin pump—a long way from boiling syringes.

As for keeping track of her blood glucose, that was a little different—at-home blood glucose meters were still decades away. Youell praises the advances in at-home blood glucose testing.

“[Blood glucose testing] was done by urine sample,” says Youell. “At the drug store, we bought a bottle of Benedict’s Solution, and you put so much of it into a test tube. Then, you would add 10 drops of urine, put it in hot water and when it was a proper time, you would read it. If it were orange, you would know there was a lot of sugar spilling into the urine. If it stayed blue, you would know that there was no sugar showing.”

Youell allows herself 30 carbohydrate grams per meal and hardly eats any fat. Her standard breakfast is oatmeal sweetened with SPLENDA® and cinnamon. Lunch is usually one slice of bread with peanut butter and sugar-free jelly, or a slice of lettuce, and a half an apple, pear or orange. Dinner is where she allows herself more variety.

“I can open a can of soup and have some crackers that fill out the 30 grams of carbs. Or, I can have half of a turkey burger and some green vegetables like asparagus, green beans or broccoli. Then, a fruit exchange of some sort.”

All told, Youell says she tests her blood glucose six times per day and likes having it around 100 mg/dL before each meal. She says that it is hard for her to exercise, but she usually does arm and leg stretches for about 10 to 15 minutes a day. She also does gardening about once a week. She had a hip fracture in 1989, and ever since then it has made walking distances difficult.

Don Ray

Don Ray of North Royalton, Ohio, was diagnosed with Type 1 diabetes in the summer of 1939, just a month prior to his fifth birthday. He recalls that diabetes was referred to as “sugar diabetes” back then. The biggest difference between now and then, he says, is the current emphasis on exercise for optimal diabetes control.

“Back then, exercise was frowned upon,” says Ray. “The medical people treating me felt that sugar levels could not be controlled with insulin if sugar was being burned off with exercise… I wasn’t permitted to take gym class or actively participate in recess during my early school years… I wasn’t allowed to be a member of any high school sports team until 1952—my senior year.”

When asked what he feels are the biggest changes in diabetes care since his diagnosis, Ray ran off a laundry list of things, among them:

• The many types of insulin now available
• Home blood glucose meters
• The insulin pump
• Glucose gels and tablets
• Diabetes educators
• Diabetes camps for children

Ray says that he plans his meals every day. He keeps his calories to around 2,000 daily, while usually eating two eggs for breakfast with a piece of toast, a small glass of juice and a medium glass of milk. Lunch and dinner are similar—usually consisting of meat, poultry or fish; a vegetable; a medium glass of milk; and occasionally a dessert of fresh fruit.

“I usually test my sugar levels five times daily,” says Ray. “My attitude is: Why guess where your sugar count is? Test it and you’ll know for sure.”

Rays says that his A1C has been in the low 6s for the past several years and he tries very hard to maintain that level.

“My glucose meter will reflect counts as low as 90 to as high as 170 [mg/dL] during some days, but I’m fairly well in a range of 100 to 150 most of the time. Rarely do I reach a 200 level.”

Ray started wearing an insulin pump in 2005, and maintains a basal of 30 units per day, with 8 bolus units delivered before each meal. He was in a serious automobile accident in 1998, which he says impaired his ability to exercise the way he always liked to. He says he played organized football into his early 40s, baseball until his late 40s and basketball until he reached the age of 60.

“Presently, my exercise is somewhat limited to walking but that is not as often as I would like—the legs just don’t allow for too long of a distance.”

How to Become a Medalist

The Joslin Medalist Program is open to everyone. Some form of documentation is required (e.g., records of the date of diagnosis with diabetes and the date of beginning insulin treatment).