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Jack Collins was diagnosed with type 1 diabetes (T1D) in 1972 — about 50 years ago. Despite having a blood sugar level over 600 mg/dL, it was another two weeks before his first appointment at the Joslin Clinic in Boston, MA when he started taking insulin.
Collins joined the T1D Exchange Board of Directors in 2018.
“…believing I wouldn’t live past 45 years old.”
“I have one very vivid memory from a training visit at Joslin,” recalls Collins. “There was a party going on for a woman who had ‘survived’ 30 years after her diagnosis. I quickly did the math in my head and determined that I would be lucky to live until I was 45 years old!”
Thanks to remarkable advancements in the care and management of T1D during the last 50 years, Collins celebrates his 65th birthday this year.
“I lived most of my life believing I wouldn’t live past 45 years old,” says Collins. “It wasn’t until eight or nine years ago that I realized it wasn’t true.”
While some might find that anticipated deadline daunting, Collins says it motivated him to do as much living as possible.
“I figured, if I get to 45 years old, it’s gonna be an achievement. I was gonna try to get as much done as I could, try to squeeze it all in,” he explains — which included a degree from Suffolk University in accounting, two marriages, two children, and plenty of life experience along the way.
“When I surpassed 45 years old, I used to feel like I was living on borrowed time. But I don’t feel that way anymore.”
Managing type 1 diabetes in the 1970s
“After my diagnosis, I was told I couldn’t be a pilot, a commercial truck driver, or a police officer,” says Collins — all of which are careers people with T1D can pursue today.
Without blood glucose meters back then, Collins remembers relying mostly on how thirsty he felt in order to determine if his blood sugar was too high on any given day.
“I was lucky to have a great doctor from the moment I walked through the doors at Joslin,” says Collins. “Dr. Donald Barnett was my doctor for 35 years and I miss him dearly. He realized quickly that putting me on a strict diet by weighing my food wasn’t going to work for me as a teenager. He put me on a sliding scale program that I could adjust my dose based on what I was going to eat.”
Before 1978, the only insulin available was short and long-acting options derived from pigs and cows. Collins wouldn’t start taking synthetic insulin (Humulin) until eight years into life with T1D.
“I checked my blood sugar by putting urine in a test tube and dropping a pill-like thing into it. It would change color based on your blood sugar,” recalls Collins. The results of this method offered a wide range of what your blood sugar had been several hours prior to the test.
Tackling complications of 50 years with T1D
The decades Collins managed and survived T1D without today’s insulin and technology options did take their toll. But he’s endured diabetes-related complications with the same gusto as everything else.
“I’ve had 12 or 13 total laser treatments on both eyes for ongoing blood vessel leakage,” explains Collins, referring to diabetic retinopathy. “Dr. Lawrence Rand has saved my eyesight many times over!”
Collins has also dealt with his share of neuropathy in his toes — losing a few toes via amputation.
“When I had the toe removed on my left foot first, I needed 60 treatments of hyperbaric oxygen therapy to save the rest of my foot,” says Collins. “I couldn’t wear my insulin pump during the treatments.”
Collins later struggled with an infection in his other foot.
“I will forever thank God for the newer procedure I had done last year for an infection in my right big toe,” says Collins. “First, they did an angioplasty to improve the blood flow to my toe. It failed! They then did a new minimally invasive procedure that turns a vein into an artery to avoid a blockage in the artery.”
“Dr. Lars Stangenberg performed the procedure. He had done less than 10 of them at the time, and it is less than 50% successful. Mine was not successful but for an unknown reason another vein — not the intended vein — did convert based on some type of backup process they do when they’re in there. To this day he can’t explain it and my only explanation is to thank my mother who had died about a week before the infection started.”
50 Years and counting
What 50 years of managing T1D and its complications gives Collins today is simply gratitude. Today, he wears a t:slim insulin pump and a Dexcom continuous glucose monitor. His latest HbA1c was 6.4% — an achievement he’s incredibly proud of.
“I’m thankful for the medical advances I’ve seen,” says Collins, “and can only hope that we all blaze a trail for those that follow until a true cure can be found for this brutal disease!”
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