DOC News June 1, 2007
Volume 4 Number 6 p. 3
© 2007 American Diabetes Association
Meet Gladys: 83 Years and Counting
Irl B. Hirsch, MD
One lunch hour this past January, I received a phone call that would have
an impact on me, most likely for the rest of my life. A reporter from a local
radio station called, asking me to comment about a woman named Gladys Dull who
was about to celebrate her 90th birthday. At the time, this didn't seem
particularly newsworthy. But this wasn't any 90th birthday, in a day and age
when centenarians are so commonplace we hardly notice when the birthdays are
announced on NBC's "Today Show."
The remarkable aspect was that Gladys, now 90 years old and barely 100
pounds soaking wet, was celebrating her 83rd year receiving insulin. In 1924,
when she was age 7 and living in North Dakota, her adoptive parents made the
3-day trip to Rochester, Minn., to save their daughter from dying from
ketoacidosis. Commercial insulin had been available only about a year. They
arrived at the Mayo Clinic with little time to spare to save their daughter
from certain death.
Gladys and her parents learned how to inject this crude pancreatic extract
recently named insulin. (The initial insulin in the U.S. was manufactured by
Eli Lilly and Company; in a famous meeting between George Clowes, PhD, of Eli
Lilly and the Toronto team that discovered the insulin, an agreement was
signed permitting the Indianapolis company to mass-produce insulin soon after
its discovery.) But Gladys also learned diabetes is much more complicated than
simply taking painful shots each day. In diabetes education classes in 1924,
patients were taught the secret for success was consistent content and timing
of their insulin and meals (to the point of weighing everything on gram
scales), regular exercise, and adequate rest. It seems some of our basic
recommendations haven't changed at all.
But let's not forget what the world was like in 1924. We didn't have
television, and radio was so new it was not yet available to Gladys's family
in North Dakota. We didn't have antibiotics yet, and in fact Gladys's
biological parents both had died from influenza a few years earlier. The
couple that raised her were kind neighbors. Obviously, these wonderful people
treated her as if she were their own child by saving her life and obtaining
her first insulin.
Soon after my phone call from the radio station, I decided to meet this
remarkable woman myself, and on a cold Saturday in March I traveled to Walla
Walla, Wash., to meet Gladys and her son, Norman. We spent several hours
talking, and I was fortunate to have this interview videotaped.
Gladys is still quite sharp despite a "small stroke" several
years ago. Her greatest problem is her vision, not from retinopathy or even
cataracts, but from macular degeneration. She insists her secret for longevity
is her consistent diet, eating the same quantity of food at the same time each
day, day after day, month after month, year after year. I later learned from
her physician that Gladys does not always follow her meal plan as well as I
was led to believe, but hey—after 83 years on insulin, it seems to me
she can treat herself on occasion.
Not surprisingly, there have been several close calls. At age 9, she
developed an acute appendicitis. Given that no one in North Dakota wished to
perform emergency surgery on a 9-year-old girl with type 1 diabetes in 1926,
her parents had only one option: They again took her to Mayo Clinic, where she
arrived in a coma from ketoacidosis. She obviously survived although my guess
is, given that it was still the preantibiotic era, her chances of survival
were slim.
She also was encouraged not to have children, but she chose to ignore that
advice. She acknowledges it was a difficult pregnancy, but wouldn't tell me
the details. But Norm, now 60 years old, was healthy and today lives 30 miles
away from his mother.
Gladys is also a history book on the evolution of insulin. She recalls the
introduction of protomine zinc insulin (PZI) in the 1930s and later Lente and
NPH insulin. Today she takes NPH and insulin lispro (Humalog, Eli Lilly). She
was fortunate in that she did not have any of the terrible allergic reactions
so common with insulin users in the 1920s.
One of the greatest surprises to me was how Gladys monitored her diabetes
over the years. Certainly, during her pregnancy 60 years ago, the only glucose
monitoring that could be performed at home was urine glucose testing, which
she religiously did as recommended by her physicians. But she continued her
urine glucose testing for decades after her pregnancy. Indeed, despite the
fact that home blood glucose monitoring was available for patients in the
early 1980s, Gladys only started testing her blood glucose at home 5 years ago
after the death of her husband. Not surprisingly, hypoglycemia has been the
major problem for Gladys over the years, but this seems to be less of a
problem now. When I asked if she might like to try an insulin pen instead of
the older syringe and vial, both she and Norm were quick to point out what
they were doing was working, and changes often resulted in problems. And I
must agree. Who am I to argue with such
success?
Gladys now lives with a caregiver in her own house. Of all the awards she
has received for her longevity receiving insulin, the one she is most proud of
is the 75-year medal from Eli Lilly. And who can blame her? We should all
celebrate with Gladys and her family. Because what she has done is put the
topic of diabetes in perspective for all of us. Is her long life due entirely
to her meticulous care, or are genetic factors involved too? There are
probably many reasons for her longevity, including a bit of luck starting with
her initial diagnosis and the emergency appendectomy that followed two years
later. But there are likely other Gladys Dulls who will be celebrating 80, 85,
and even 90 years receiving insulin. And my comment to all of these people:
Thank you for sharing your stories, as they are inspirational to everyone with
diabetes today, especially the children newly diagnosed with this chronic
condition and their parents. 
Footnotes
| |
Irl B. Hirsch, MD, is editor-in-chief of DOC News and medical
director of the Diabetes Care Center at University of Washington Medical
Center.
|
|
CiteULike 
Del.icio.us 
Digg 
Reddit 
Technorati What's this?
