Bruce Carlson and his wife Nancy
Welcome to Breakthrough T1D Bay Area’s blog, One on 1, a series of interviews with people who live with type 1 diabetes (T1D). Members of our community talk about how T1D affects them, how they manage it, and what they have accomplished despite it. He is one of the 50% people with T1D diagnosed as an adult. And, he’s been living with it for more than 50 years.
When were you diagnosed with T1D and what was it like for you at the time?
In 1963 at age 27, my sixth year of teaching math at Orville Wright Junior High in Westchester, I began to be always thirsty and frequently urinating. Even though we called my doctor for advice, and even though the symptoms are typical and relatively easy to diagnose, I never got a return call – perhaps the fault of a nurse we had talked to, so I just kept on through summer vacation dealing with our first house and a new infant son. I am 6′ 2″ tall, and normal weight is 185. In August I weighed 140 and had flu/cold-like symptoms, so we went to the hospital where they immediately recognized I was diabetic and began insulin and training. I thought “I’ll never be able to eat popcorn again!”
How has your outlook evolved since then?
In spite of my popcorn fear, I have lived a normal, happy, and varied life, completing teaching and serving as a counselor, vice-principal and principal until I retired in 1991. Our activities have included lots of international and US travels and vacations, concert and theater subscription series, home-based household improvements and automotive maintenance and repairs, backpacking and camping, photography, and growing with our children until they entered college. My wife Nancy has been a major support and reason for my success.
How has your management improved with new tools available? What has made the biggest difference for you?
There have been significant changes. Originally I was told to test my urine for sugar with test strips. I soon realized what was in my bladder for many hours had little to no relationship to my current blood sugar, so I stopped that procedure and relied exclusively on my own perception, which was a very inaccurate indication. At the start, I was using glass syringes with replaceable needles, and needed to boil the syringes every morning for sterilization. I was also using one dose of 24 hour lasting insulin, which meant eating was by need, not at scheduled times. I had many low blood sugar incidents, several requiring ambulance/hospital treatment; one on the freeway where I stopped and lost consciousness.
The first major improvement was the development of the home meter for measuring blood sugar in the mid 1980’s. It provided improvement in information to help me control my eating. Second, in the mid 1990’s, a Kaiser dietitian taught me to use a smaller dose of 24 hour Lantus combined with faster acting 4 hour (now Humalog) taken at meal time by amount depending on carbohydrate count (estimate). This allowed me to eat what and when it was appropriate; my last A1c, March, age 81, was 6.6.
How do you manage T1D while traveling for long periods of time?
I carry a test meter, strips, and insulin in my carry-on with 2 insulin vials that are open in a stainless thermos with ice cubes. A second thermos in checked luggage carries two unopened vials. If there is a significant time change, I modify or discontinue Lantus using more or only Humalog until settled in new time zone. Whenever we are away from home, whether for the day or weeks, I always carry my meter, strips, and a needle with 10 or so units of Humalog. I typically test before each meal, if I am going to drive, and before bed – about 6 times per day. My typical daily insulin use is 15 units of Lantus when I get up, and about 10 Humalog units total for my meals (varies, of course). We did quite a bit of motorhome traveling which permits “home cooking” avoiding french fries and the like; I usually do not eat desserts; sometimes a “cheese plate.”
As an educator, what would you like to teach the general public about T1D?
Symptoms, treatment, ability to live an almost normal life. I frequently explain the difference between T1D and T2D, as few people (understandably) know.
