More and more people with type 1 diabetes are reaching >50 years duration of diabetes, thanks to the tremendous advances in the therapeutic options for diabetes over the past three decades. Four male and 2 female patients, aged 53-73 years, with duration of diabetes 51-69 years, received care by the author for 28-53 years. All physical status data, HbA1c, total cholesterol, HDL-cholesterol, LDL-cholesterol, Triglycerides, Serum Creatinine, eGFR, and urinary albumin have been available since 1990. The bodyweight of three male patients was moderately or significantly increased, that of the other patients remained at normal levels. Typical HbA1c levels ranged between 6-8% in 5 patients, between 7-9% in 1 patient. LDL-cholesterol levels ranged between 1.3 -3.5 mmol/l, HDL-cholesterol and triglycerides were normal throughout the observation period, serum creatinine, eGFR were within the normal range, 3 patients had microalbuminuria. All patients were C-peptide negative. At present, all patients have mild somatic and autonomic neuropathy and mild background retinopathy. Based on ultrasound examination, coronary CT and cardiac examination, 3 patients have moderate arteriosclerosis, among them 1 case underwent coronary artery bypass graft surgery 19 years ago, and currently we have performed coronary angiography and stent implantation in the other 2 cases. All patients have been receiving MDI therapy since the 1980s, have been using analog insulins for 18 years, one patient has been using an insulin pump for 16 years, and all six patients have glucose control with CGM. All patients are taking statins, and have mild to moderate hypertension. Several studies have dealt with hundreds of patients with >50 years duration of diabetes, but these include multicentre data from the National Registers and only cross-sectional analysis. In contrast, my own patient population summarizes the results of long-term data and comprehensive cross-sectional analysis.

Jozsef Fovenyi has completed his PhD at the age of 39 years from the Semmelweis University, Budapest. He became an associate professor at Semmelweis University in 1986. From 1978 to 2001, he was head of the department of internal medicine at the Péterfy Sándor Hospital in Budapest. After retiring, he works at the Hospital’s Diabetes Clinic. He has qualifications in internal medicine, endocrinology, diabetes and obesity. He was a board member of the Hungarian Diabetes Association for decades and also held positions at EASD. He has published 148 articles, partly in English, 26 book chapters, 16 books, 22 patient education books and booklets.