Who are the Joslin Medalists?
Hyperglycemia is a major cause of diabetic vascular and neuropathic complications. However, a significant number of diabetic patients, known as the Joslin 50-Year Medalists, remain free from various complications such as nephropathy and proliferative retinopathy after 50 years or more of diabetes.
Joslin Diabetes Center ’s 50-Year Medal Program recognizes individuals who have lived with insulin-dependent diabetes for 50 or more years to honor their accomplishments in diabetes management.
Learn more about the 50-year medalists.
Why are they so important?
For the first time, a large number of individuals who have survived fifty or more years with type 1 diabetes are being studied to determine factors, which may allow them to be resistant to the ravaging effects of diabetes. With support from JDRF, the Joslin Diabetes Center in Boston is currently studying Medalists from within the United States in an effort to identify these factors. We have been characterizing genetic, environmental, psychological and physiological factors, which may contribute to survival with extreme duration of diabetes. The Medalist population provides a unique opportunity to study individuals with extreme duration of diabetes.
What can I do?
Become a medalist
I am already a medalist. What is the next step?
What research has come about due to the 50-year medalists study?
In the first phase of the study, which took place three years ago, we asked Medalists to complete an extensive medical history questionnaire and provide some laboratory data from their doctor. The results from these questionnaires and lab results provided the very interesting finding that close to 50% appear to have escaped serious complications, which occur in almost all diabetic patients by 30 years of duration. These complications include eye disease (retinopathy), kidney disease (nephropathy) and nerve disease (neuropathy). Further, we have found that both genetic and metabolic factors are important in the prevention of complications in type 1 diabetic patients. The results showed that as a group, Medalists have controlled their blood glucose levels very well for many years. In addition, hemoglobin A1c, a measure of chronic glucose control, does not seem to correlate with the various complications described above. These are very exciting findings which have been published in the journal Diabetes Care in 2007.
In the three years since the start of the second phase of the Joslin 50-Year Medalist study, we have studied approximately 400 Medalists with the support of JDRF. These Medalists traveled to Joslin Diabetes Center in Boston for the study. We have been examining the status of complications with respect to eye, kidney, nerve and heart function. Metabolic changes in blood and the ability to produce insulin in the Medalists are also studied. Genetic studies are underway to determine whether these extraordinary survivors have typical type 1 diabetes or a different, yet unknown type of diabetes. Data from over 350 people have been analyzed and have led to very exciting discoveries. These new findings have shown that most Medalists have clinical and laboratory findings consistent with “typical” type 1 diabetes. 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. From a complications point of view, these findings are very exciting since they showed that 40% of the Medalists have factors or genes, which are protecting the Medalists from developing diabetic eye disease.
In addition to the exciting findings regarding diabetic complications, the results from the Medalists have also yielded an unexpected finding regarding pancreatic functions. Surprisingly, over 20% of Medalists appear to produce a small amount of insulin. This finding can be important and exciting since it suggests that some type 1 diabetic patients may still make insulin even after 50 years of diabetes. If this finding can be confirmed, then it raises the possibility that many type 1 diabetics may still have some functional pancreatic tissues, which could make insulin. Thus, we have begun to bring some Medalists back to Joslin for further studies to determine whether their pancreas can respond by producing more insulin when stimulated. In a new study supported by JDRF, we want to continue these studies and recruit 300 more Medalists. More Medalists are needed for the studies in order for us to identify the new genes and other factors, which are responsible for protecting the Medalists from complications and even preserving some of the function in the pancreas.
How to become a Joslin Medalist?
This program is open to everyone who has documentation of 50 or more years of insulin dependent diabetes. There are no physical restrictions for these awards, however some form of documentation is required. If you or a loved one has lived with insulin-dependent diabetes for 50 or more years, the Joslin Diabetes Center would like to recognize this achievement. Once the 50-Year Medal has been awarded we sincerely hope you or your loved one will consider taking part in this unique and important research study. If you are interested in participating or have any questions please contact Ms. Leah Whelan at (617) 713-3481 or at 50YMS@joslin.harvard.edu
As a medalist, you can make a difference in the lives of Type 1 diabetics around the world by donating your tissues for diabetes research. Your tissue gifts will help researchers better understand the causes of this disease and the contributing factors which enable medalists, such as yourself, to live so long with diabetes. With a better understanding of this illness, scientists will be able to develop new and improved treatments, and hopefully, bring us one step closer to a cure.