NEW YORK (Forbes HealthDay News), November 14, 2007:
Bob Cleveland may be 87 years old, but he still remembers the day he was first diagnosed with type 1 diabetes -- in 1925.
"I went to the hospital at five years of age, and I thought to myself, 'OK, I'm going to die.' Because never having been to the hospital before, I just thought that's where you went to die," said Cleveland, of Syracuse, N.Y.
He didn't die. The hospital personnel just tested and confirmed that he had type 1 diabetes. But Cleveland has gone on to enjoy life to the fullest, pursuing mountain climbing and other outdoor adventures, having a rewarding career as an accountant at General Motors, and raising a family -- with his wife, Ruth, 86 -- all the while monitoring his blood sugar and taking insulin as needed each day.
"He amazes me," Ruth Cleveland said. "He's still able to take care of the yard, even drive a 32-foot motor home to Florida -- and he does it well."
People like Cleveland -- and his older brother Gerald, who is 91, and also has type 1 diabetes-- serve as a reminder on November 14, World Diabetes Day, that amid the grim statistics lies the notion that a life with diabetes can be active, healthy and without limits.
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According to the World Health Organization, 3.2 million people worldwide die from diabetes each year and, if improperly managed, the illness can shorten lifespans by an average of 12 years. More than 18 million Americans have diabetes, with 95 percent developing the obesity-linked type 2 disease.
Type 1 disease usually begins in childhood and is linked to an inability of the insulin-producing cells to do their job. It typically means a lifetime of blood glucose monitoring and insulin supplementation.
Most type 1 diabetics don't let it overwhelm them, however.
"Yes, diabetes is something that you have to deal with, but it's just another part of your life," said 73-year-old Alan Lewis, professor emeritus of oceanography at the University of British Columbia, Vancouver.
Lewis was first diagnosed with type 1 diabetes 69 years ago but has also spent most of his adult life as a competitive swimmer. He only eased up on the competition at age 71, after a back injury got in the way of his breaststroke.
That setback is only temporary, he said. "The old juices are still flowing, so I have a feeling that I will get back into competitive swimming in about a year," Lewis said.
Experts say that type of can-do attitude, coupled with steadfast attention to blood sugar monitoring, diet and exercise, are the keys that allow diabetics to live well into their 70s, 80s, and even beyond.
Diabetes care has certainly improved since the Clevelands and Lewis were diagnosed as children. Today, high-tech pocket-sized glucose monitors mean quick, easy blood-sugar monitoring is literally at your fingertips. Insulin delivery is also easier than ever.
In the 1930s and 1940s, however, blood sugar could only be tested at home via urine sampling, which provided patients with only a much-delayed look at blood glucose levels. Medical crises -- moments when sugar levels dipped so low a coma might result -- were common.
"When you talk to the elderly with diabetes who have gotten to live to today, they have lived through a time and place when we really couldn't take care of diabetes very well," said Dr. Larry Deeb, immediate past president for medicine and science at the American Diabetes Association.
"However, even then, they made the commitment to take care of themselves," he added. "They reviewed their urine glucose, they took their insulin every day, they watched their diet and were active." "It takes a huge commitment to take care of yourself with diabetes, to mind it every day," he said. "There's never a day off." And yet, most elderly diabetics say that managing their diabetes quickly became routine.
"I think I was so focused on what was of interest to me in my life that diabetes was simply something I got used to," Lewis said. "It became just a hurdle I needed to go through to get someplace."
Indeed, many older diabetics may have lived so long, because "they have turned their diabetes into an asset," explained Dr. Sheri Colberg, a Virginia Beach, Va., exercise physiologist who has done much research on diabetes, longevity and lifestyle.
Colberg -- a type 1 diabetic herself -- interviewed dozens of diabetic seniors for her book, 50 Secrets of the Longest Living People With Diabetes. "I actually had some people who told me, 'Diabetes saved my life,' " she said. "They said to themselves, 'If I don't do this, I am going to die sooner.' They used diabetes as an incentive to adopt a healthier lifestyle, better eating patterns. And to stay physically active -- every one of them was physically active."
That's something Cleveland and Lewis agreed with.
"I've always been more of an outdoor person and more interested in exercise, games, swimming, thing like that," Cleveland said. "They were definitely advantageous for a diabetic."
Lewis added that the discipline and energy expenditure demanded by competitive swimming forced him early on to closely track his blood sugar highs and lows.
"I would advise people to test frequently, to get to know what your own [blood sugar] profile is, and then to set up a game plan to deal with those effects," he said.
Exercise also helps people stay slim, which is always a good thing when it comes to either type 1 or adult-onset type 2 diabetes, Deeb said. Indeed, all of the advice for people with type 1 disease would apply to the greater population of people with type 2 illness, he said.
Another key to a long, healthy life with diabetes: the support of loved ones.
Lewis said his wife, Carolyn, has helped him manage his diabetes for more than 50 years. Cleveland credits Ruth with helping him get him through the tough times.
"I got married at age 27, and my wife has done the most wonderful job of helping me that anyone ever could," Cleveland said.
Ruth Cleveland said her husband initially kept his diabetes a secret from her when they were first courting more than 60 years ago, due to the stigma then attached to the disease.
"He claims he was afraid to tell me, afraid that I wouldn't want to continue seeing him," she said. Those fears were unfounded. "If anything, it made me appreciate him more and want to be a part of his life," Ruth said. "Which has turned out to be wonderful."
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