Long-Term Type 1 Diabetes 'Survivors' Give Clues to the Disease

Although it's long been thought that people with type 1 diabetes cease to produce any insulin after they've had the disease for a while, new research suggests that the insulin-producing beta cells destroyed by type 1 diabetes may actually be in a constant state of turnover, even in people who've had diabetes for decades. This new research stems from a study of people who've had type 1 diabetes for at least 50 years and have been awarded the Joslin Diabetes Center's "50-Year Medal." In fact, the impetus for the study came from one of the medalists who mentioned to her doctor that she believed her body was still making some insulin.

"I knew I still produced insulin. I don't do it all the time, but sometimes I need a lot less insulin, and the doctors proved on one test that I still did make some insulin," said medalist Elizabeth Saalfeld from Springfield, Va., who was diagnosed with type 1 diabetes in 1945 at age 9. "In our study, we made the unexpected finding that about two-thirds of the medalists still retained the ability to have positive C-peptide results, which is an indication that they could still be making insulin," said the study's senior author, Dr. George L. King, chief scientific officer at the Joslin Diabetes Center in Boston. "It was a surprise because they've had diabetes for so long."

Results of the study were released online Aug. 10 in advance of publication in an upcoming print issue of the journal Diabetes. Type 1 diabetes is believed to be an autoimmune disease in which the body's immune system mistakenly attacks the beta cells in the pancreas. When enough beta cells have been destroyed, the body is no longer able to produce sufficient enough amounts of insulin to properly metabolize the carbohydrates in food. Someone with type 1 diabetes must replace that lost insulin through daily injections.The current study included 411 living diabetes medalists, and a post-mortem pancreas analysis from another nine medalists.