Researchers at the The Joslin Diabetes Center and the Juvenile Diabetes Research Foundation (JDRF) have completed a study of 158 people who have lived with documented type 1 diabetes for 50 years or more, and who comprise a portion of the Joslin 50-Year Medalists cohort. The researchers concluded that a significant percentage of this unique group of patients developed little to no diabetic eye disease over time. The study results were presented at the June 2012 American Diabetes Association 72nd Scientific Sessions.
The Joslin Diabetes Center
The Joslin Diabetes Center, a teaching and research affiliate of Harvard Medical School, is an internationally recognized diabetes treatment, research, and education institution. The Joslin website provides online diabetes articles and information, including Diabetes Words and Phrases and The Joslin Guide to Diabetes: Revised Edition.
The Juvenile Diabetes Research Foundation
The goal of the Juvenile Diabetes Research Foundation (JDRF) is to improve the lives of all people affected by type I diabetes by accelerating progress on the most promising opportunities for curing, treating, and preventing type 1 diabetes. The JDRF provides an online diabetes support team, diabetes questions and answers, Life with Diabetes E-Newsletter, and a listing of current clinical trials.
The 50-Year Medalist Study
From Joslin’s 50-Year Medalist Study Background:
For the first time, a large number of individuals who have survived 50 or more years with type 1 diabetes are being studied to determine factors that may allow them to be resistant to the ravaging effects of diabetes… We have been characterizing genetic, environmental, psychological, and physiological factors, which may contribute to survival with extreme duration of diabetes.
In the first phase of the study, which took place seven years ago, we asked Medalists to complete an extensive medical history questionnaire and provide laboratory data from their doctors. The results from these questionnaires and lab results provided the interesting finding that close to 50% appear to have escaped serious complications, which occur in almost all diabetic patients by 30 years of duration.
In the five years since the start of the second phase of the Joslin 50-Year Medalist study, we have studied approximately 550 Medalists with the support of JDRF. The eye studies, which took pictures of the back of the eye, showed that about 40% of the Medalists do not have serious eye disease even after 50-80 years of type 1 diabetes and less than 10% of the Medalists have any kidney problems.
About Diabetes
From What is Diabetes? at VisionAware.org:
Diabetes is characterized by a high level of glucose in the bloodstream, also known as hyperglycemia. Glucose is the principal circulating sugar in the blood and provides energy to all cells in the body. These cells cannot use glucose, however, without the help of insulin. Insulin is a hormone produced by the pancreas that converts sugar and starch from food into the energy needed to fuel everyday activities.
Type 1 diabetes (formerly called juvenile-onset, Type I, or insulin dependent) has the following characteristics:
- It usually occurs before age 30 and affects 5%-10% of individuals with diabetes.
- It occurs when the body produces little to no insulin (insulin deficiency).
- Glucose continues to rise in the bloodstream because it cannot enter the body’s cells.
- The body’s immune system destroys its own insulin-producing cells in the pancreas, for reasons that are not yet clear to researchers. Possible reasons include genetic factors, viruses, or a defect in the body’s autoimmune system.
- Insulin injections are required to sustain life.
How Diabetes Affects the Eyes and Vision
Although individuals with diabetes are more likely to develop cataracts at a younger age and are twice as likely to develop glaucoma as are non-diabetics, the primary vision problem caused by diabetes is diabetic retinopathy, the leading cause of new cases of blindness and low vision in adults aged 20-65:
- Diabetic retinopathy occurs when there is damage to the small blood vessels that nourish tissue and nerve cells in the retina.
- When the term proliferative is used in relation to diabetic retinopathy, it describes the growth, or proliferation, of abnormal new blood vessels in the retina.
- Proliferative diabetic retinopathy affects approximately 1 in 20 individuals with the disease.
More about the Study
From a EurekAlert press release:
“Joslin’s attempt to characterize diabetic retinopathy is an important starting point for preventing or treating this complication of type 1 diabetes,” said Helen Nickerson, JDRF’s senior scientific program manager of complications therapies.
“The understanding that these Medalists have been relatively unaffected by such a common complication leads us to infer that there may be biological or genetic protective factors that could be utilized to benefit other people with type 1 diabetes.”
Helpful Diabetes Information
You can find additional information about diabetes and diabetic retinopathy at the following resources:
- How to Become a Joslin Medalist: A history of the program and the application process
- An Introduction to Diabetes and Diabetic Retinopathy at VisionAware.org
- Helpful Diabetes Resources at VisionAware.org
Sources: EurekAlert!; Joslin Diabetes Center