Medalist Study Updates
Joslin Medalist Study Update Winter 2010
Happy New Year! We are writing to let you know about several important events for the Medalist Study. The study has been selected and received funding to apply for a special research project from the National Institutes of Health. We have also had breakthroughs demonstrating that there is still insulin being made in several 50-Year Medalists, and we are beginning a follow-up stage to the study. None of this would have been possible without your participation in all aspects of the study. A special thank you from Drs. King and Keenan, Josh and Leah for your willingness to come to Boston and providing information on your extraordinary lives. Your contributions have ignited the scientific community.
An especially fortunate example of this is the invitation to apply for a grant from the National Institutes of Health which would allow us to examine factors protecting against complications and complete destruction of insulin producing cells. We are fortunate to have investigators here at the Joslin who are international leaders in their fields adding to the Study team. Additionally, we hosted a symposium on the Medalist Study in early September of this year. Experts from Europe and the United States came to hear and talk about future directions of the Study.
From the research and data done in the past year, we will be submitting several presentations to the American Diabetes Association’s research conference in Orlanda, FL this year. These will include studies of the amount of blood flow in eyes associated with protection from diabetic retinopathy, continued evidence of insulin production in the pancreas of Medalists, and auto-immune diseases.
The basic characteristics of the 50-Year Medalist Study participants remain steady as our numbers reach over 550, well on our way to our funded goal of 750. The gender make up of the study remains about half men (47%) and half women (53%). The average HbA1c is 7.3%, average age is getting a little younger than last year at 67 compared to 68. Age at diagnosis is remaining constant at 11 and duration has dropped a small amount to a mean of 56.2 years. Cholesterol levels look great with an average of 164 mg/dL, HDL levels are very high for the age of the group at 63.1. The average insulin dose has remained steady at 0.46 units per kilogram. We recently completed an examination of the presence of the genetic variations associated with increased risk of type 1 diabetes and over 93% of the study has one or more of them. The rates of complications also remain low with only 60% having proliferative diabetic retinopathy, 13.1% kidney disease, 60% with nerve disease and about half (48.3%) with large vessel disease.
As we talked about in the last update letter we are calling everyone back for a test to study the degree to which your body may still be producing insulin. This is important because we have found insulin in EVERY pancreas we have examined so far, the test that we do (mixed meal tolerance test) challenges your pancreas to excrete any insulin that is there. Even in people who did not have very high C-Peptide on their first visit were found to have insulin in their islet cells. Our studies so far suggest that there is a mechanism preventing the immune system from destroying all the cells with insulin. This makes identifying individuals who are like this crucial to finding how to resist auto-immune destruction. This is why we are inviting everyone back for this test. Please feel free to contact us if you are interested and have a specific time that would work for you.
A next step in our research is to follow-up with you regarding your life with diabetes. Enclosed is a paper copy of a follow-up questionnaire we would like you to fill out. Additionally, we have put it online if you prefer to complete it that way. It can be accessed at: http://tinyurl.com/yktnwzh.
Finally, the website has been updated and, hopefully, easier to find on the Joslin homepage. The webpage can be found at: http://www.joslin.org/joslin_medalist_program.html. Please use the chat rooms and boards to be in touch with other Medalists. It is not just for study information; it is there for the community. There is link to the online version of the update questionnaire on the website as well. As always, the Medal application can be downloaded and there. Additionally, information regarding organ donation can be obtained at http://ndriresource.org/.
On behalf of the whole Medalist Study team, we appreciate your participation and continued support. We look forward to keeping you updated about the study, so keep an eye out for letters from the Joslin with the 50-Year Medal.
Sincerely,
George, Hillary, Leah and Josh
The Medalist Study Team
Click on the links below to see the past Medalist Study updates: