Survivor!-79 Years with Type 1 Diabetes Has Not Slowed Down Karl Smith

When Karl Smith was first diagnosed with type 1 diabetes in August 1922, he started out on what he calls “starvation” to treat his condition. He stayed on that “treatment regimen” until December 24, 1922.

“I was ready for the grave-there wasn’t much left of me,” says Smith, who developed type 1 diabetes at the age of six. “I was one of the first. My doctor was a good friend of Banting and Best [the two men who discovered insulin]. He got my first dose insulin for me.”

Nothing but a Few Broken Bones and Appendicitis

Smith reports that his health has been excellent throughout his life. Aside from the normal health problems, such as broken bones and appendicitis, he has had no diabetic complications and, at age 85, continues to play tennis and golf and ride his motorcycle.

“I think my health is a lot better than most people my age because of the way I’ve lived,” he says. “I’ve been very careful about most things-particularly the blood sugar.”

The key to Smith’s success has been the teachings of his original doctor.

“He said ‘Keep your blood sugar down,’ and I have.”

Practiced Intensive-Insulin Therapy a Half Century Before the DCCT

About 60 years ago Smith decided to go on his own version of intensive-insulin therapy. He started taking four shots of Regular insulin a day spaced six hours apart from each other.

“In the morning before breakfast I take eight units of Regular, the same before lunch, the same before dinner, and 2.5 units at 1 a.m.”

Smith tests about seven times a day and tries to keep his blood sugars between 70 and 110 mg/dl.

“I wouldn’t be alive if I hadn’t,” says Smith, whose last HbA1C was 5.5%, which is where he likes to keep it. If he has a blood sugar level above 200 mg/dl, which he says very rarely occurs, he’ll take about three units of Humalog to bring it down.

Watching What He Eats and Getting Plenty of Exercise

“I eat the same thing anyone else does, except that I’m careful with fat. And I eat the same number of carbohydrates, proteins and fats every day. I count everything, of course. I’m on about 1,500 calories a day.”

Smith has stayed the same weight for his whole life.

“My general behavior is pretty conservative. I don’t do an awful lot of drinking, though I do have a cocktail every evening.”

Smith, who has been smoking a pipe since college, has also been an athlete for his whole life.

“I played hockey on my high school team, hockey in college for Princeton and semi-pro hockey after college.”

Diabetes Was Never a Burden

Smith does not feel that diabetes has held him back in life. He never felt particularly depressed about it and never rebelled against it.

“I never knew anything else,” he says. “I did want to go hiking in Alaska, but I thought it was a little too risky. When the war came along, I could not get into any of the services but I was able to join the civilian technicians and I traveled with the navy.”

As he has gotten older, Smith’s diabetes has become more difficult to control.

“In recent years I’ve had a fair amount of trouble with hypoglycemia-but that’s part of intensive-insulin therapy. It’s what you’ve got to expect. After I look at all the statistics, and from what my doctor at the Joslin Clinic tells me-he said I’m an amazing person-I feel rather proud of myself for having done this, when the odds have been so terrible against everyone else. An awful lot of people don’t pay enough attention to their diabetes.”

Advice to Other People with Diabetes?

“Keep excellent control of the blood sugars, get plenty of exercise, keep the weight down and stay out of trouble.”

Side Article 1

A Day in the Life of Karl Smith

•For breakfast I’ll have a small

glass of orange juice and two

slices of toast-or the equivalent

-and a cup of coffee with milk

and artificial sugar.

•For lunch I’ll have a bowl of soup

and half a sandwich.

•At 4:00 p.m., I’ll have a cup of tea

with milk, 11/2 teaspoons of sugar

and a couple of crackers.

•For dinner I have about two slices

of meat, a green vegetable and

about 3/4 cup of rice or potatoes.

•Then, before bed, I’ll have a glass

of skim milk.

•When I get up at 1 a.m., I’ll have

another glass of milk.

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