By Chris Stiehl, T1D patient for over 61 years, so far
The Joslin Diabetes Center at Harvard Medical School began in 1893 when its founder, Elliott P. Joslin, MD, first developed his interest in diabetes care. This center was among the first-ever dedicated to the study of diabetes. It is well-known for many discoveries and innovations, including diabetes camps and the introduction of honoring long-term survival for diabetes. For the last 20 years or so, the Joslin Diabetes Center has been studying those who have survived 50 years or more with type 1 diabetes (or T1D). Following the tradition of Dr. Joslin, 50-year survival medals have been awarded to those in the studies since 1972. Dr. George King has been the lead investigator on these studies, having joined the Joslin Diabetes Center in 1981.
Initially, the purpose of this study was to document the presence of eye, nerve and kidney complications related to diabetes, as well as to examine DNA and substances in the blood and urine of people with diabetes for 50 years or more. This was to identify factors which may protect from large and small vessel complications, and potentially lead to protection from aging-related diseases. In recent years, funders have investigated related issues and sought ways to extend life with T1D beyond the 50-year Medalist criterion. Indeed, 80-year and 85-year Medalists have been honored at recent meetings.
Over 1,100 Joslin Medalists have been studied so far, including examinations of eyes, skin, kidneys, heart, extremities, nerves, and cognitive functioning. The ensuing results have been enlightening and positive in many ways. For example, Medalists tend to have better bone density than the general population at the same age. There are fewer incidences of classic Alzheimer’s disease symptoms among Joslin 50-year Medalists. Medalists tend to be more outgoing and positive about their future than the general population.
Many medalists have donated their pancreases for post-mortem study. In all cases, functioning beta cells were found in these pancreases, resulting in occasional “trace” readings with respect to C-peptide even among those who have had T1D 60 years or more.
Data analyses continue for information gained from the studies of Medalist’s blood, retinal images, blood vessel scans, and retinal data. More and more results are being published from the Medalist studies each year.
There will be a Senior T1D session featuring Dr. King at the JDRF Type One Nation Virtual Summit on April 24th, 2021. Several very interesting sessions are scheduled on topics such as COVID and T1D, as well as the mental strain of restrictions of activities and interactions due to COVID. This TON Summit should be as exciting as the one last September, if not more so.
JDRF awarded an Impact Grant to Chris Stiehl to host a senior summit concerning the results of the Medalist studies on the west coast, since most of the Medalist meetings in the past have been held in Boston and many Medalists were unable to attend previous meetings due to health, travel or age limitations. This meeting will be in-person, at the LAX Marriott on August 15th, providing it will be relatively safe to meet by then. You must register in advance for this Senior Summit for Long-Term T1D. The program is still being constructed, but Dr. King has indicated his desire to participate, as well as Aaron Kowalski, CEO of JDRF.
Although the data concerning the relationship between COVID and long-term T1D is sparse, at best, at this point, it is known that transplant patients and those with compromised immune systems are at greater risk for more severe cases. We plan to have a speaker on that subject, as well as subjects requested by Medalists for the Senior Summit, such as research on new devices and tools, so-called “smart” insulins, artificial pancreases, better metrics (beyond A1c), looping and others.