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Suggestions for Living With Type 1 Diabetes

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More Than 50 Years of Type 1 Diabetes
Robert G. Spiro, M.D. - Patient, physician, researcher

I am presenting my experience with 58 years of Type 1 diabetes in the hope that it may prove helpful and offer encouragement to others who suffer from this disease.

When I was a senior in medical school in 1954 I noticed the pronounced weight loss, thirst, hunger and large urine volume which are characteristics of the onset of Type 1 diabetes and indeed when I tested my urine for sugar it was strongly positive. When I mentioned this to the Chief of the Department of Medicine he told me that medical students often mistakenly believe that they have the diseases which they are learning about.
Unfortunately he was wrong in my case and I prepared myself to live with diabetes with a minimum disruption of my career; indeed I knew that I was fortunate that I had contracted a disease for which there was a rational treatment and about which even at that time a great deal was known. Moreover, diabetes was not a stranger to me as my maternal grandfather had become a type 1 diabetic shortly after the discovery of insulin.

I was familiar with Dr. Elliott Joslin's belief in the importance of good control, since I had written an honor's thesis on this disease as a medical student. Accordingly I right away embarked on a regime of weighing my food and taking multiple daily insulin injections (even though most doctors at that time still thought that tight blood sugar control was not relevant to the prevention of the diabetic complications). Fortunately, since my wife was a chemist we were able to set up a small laboratory at home and do morning blood sugars, long before the wonderful testing systems of today were available. This was also a period when it was necessary to boil glass syringes and sharpen needles, since there were no disposable ones at that time. For the last 11 years I have been on an insulin pump which has provided many practical advantages, besides bringing my HgbA1c levels into the normal range. The pump makes it possible to deliver insulin in fractions of a unit which is important for very insulin sensitive patients like me and moreover one can adjust one's insulin delivery readily on the basis of frequent blood sugar measurements (see my link below " Suggestions for Living with Type 1 Diabetes ").

Fortunately, my early start on a strict management of my disease has enabled me to live through 58 years of diabetes without complications. The down side of this approach however has been frequent hypoglycemic (low blood sugar) reactions, which I consider a small price to pay for preventing the many serious complications of this disease, including particularly those of the eyes and kidneys.

After medical school and a medical internship we came to Harvard Medical School with which I was associated for the rest of my career (see my web site link below " Family and career "). In 1961 I joined the Joslin Diabetes Center and set up a laboratory which studied the kidney complications of diabetes and their relationship to blood sugar control (see the " My publications " link below). I am currently Professor Emeritus at Harvard Medical School (Biological Chemistry and Medicine) and Senior Investigator Emeritus at the Joslin Diabetes Center.

In 2004 at a ceremony at the Joslin Diabetes Center I was awarded their 50-Year Medal, as shown below.