Growing up, Mary Elizabeth Renner Saalfeld was allowed desserts on only a few occasions: A piece of cake for her birthday and her father's birthday, pie for Thanksgiving and fruitcake for Christmas.
She was diagnosed with Type 1 diabetes 68 years ago. Now 77 and retired in Springfield, Va., Saalfeld, who goes by Liz, is an avid quilter, loves watching sports on TV, arranges flowers for her church and has traveled the world – from China to Italy and Hawaii.
"It's my life," she concludes about having diabetes. "I think I've had a very successful life. A very full life." She worked as a medical technologist and stay-at-home mom and ran a career center for a secondary school for 22 years. Though she has undergone a triple bypass as a result of her diabetes, she says no other part of her health is affected.
Reaching this age is a special triumph for people with Type 1 diabetes. Most who were diagnosed in the early 20th century weren't expected to live past their early 50s.
Some have defeated the odds, though, in what they mainly attribute to their positive attitude about their condition and the care they take in monitoring their health. Wallace Gordon, also 77, was diagnosed with Type 1 diabetes when he was 15. "I have a general philosophy that diabetics should treat their condition with lifelong acknowledgement but not with restriction," he says. "Never let it be a preoccupation in terms of what you do or how you do it."
Type 1 diabetes limits the body's ability to produce insulin, the hormone that converts sugar, starches and other food to energy. The disease affects nearly 3 million Americans, of which 85 percent are adults, according to the Juvenile Diabetes Research Fund, an organization that funds Type 1 diabetes research. Its serious long-term effects often lead to amputation, blindness, nerve damage or heart and blood vessel damage. People with Type 1 diabetes must always monitor their blood sugar, take insulin and carefully count carbohydrates. They ideally should see an endocrinologist, a doctor who specializes in hormonal disorders and diseases like diabetes, for checkups every three months.
The condition is genetic. One of Gordon's three sons has Type 1 diabetes, as does one of his eight grandchildren. It can also affect a woman's pregnancy. Saalfeld developed high blood pressure and retained fluid when she was pregnant with her son, which resulted in an emergency cesarean section after only seven months. She cared for her son, who had multiple sclerosis – a disease that deteriorates the nervous system – until he passed away at age 32.
Saalfeld and Gordon are among 850 patients with Type 1 diabetes taking part in a study being conducted by Joslin Diabetes Center, an educational, research and clinical care organization affiliated with Harvard Medical School. The participants were selected from 3,900 Joslin medalists who have lived with Type 1 diabetes for various milestones, from 25 to 85 years.
The goal of the study is to discover why some people with Type 1 diabetes can live for a long time without developing serious complications. Participants were asked about health complications and lifestyle, including how often they exercise, how long their parents lived, their diet and whether they take medication. Researchers then tested their eyes, kidneys and hearts.
George King, the director of research and head of the Section on Vascular Cell Biology at Joslin and professor of medicine at Harvard Medical School, says about 35 percent of study participants did not have significant eye, nerve or kidney problems. Heart disease, however, has not appeared to be an exemption for any of the patients, he says.
Gordon, for instance, has had a few complications associated with his diabetes. He has had a quadruple bypass and coronary artery disease that led to the placement of stents in his artery. He has also had charcot foot, which is a weakening of bones in the foot and caused by nerve damage. Still, he says one of his greatest satisfactions is being told he looks younger than he is. "All I know is I feel pretty doggone good the way I am," he says.