Eyes on the Prize

Neal Nossaman, O.D., is well-known in Amarillo as the co-owner and optometrist at Broome Optical. He’s actively involved in many community organizations and, along with his husband Greg, is the proud pet parent of an undeniably cute French bulldog named Chloe. What many locals may not realize, though, is that Nossaman is a Type 1 diabetic and has been for 50 years.

Diagnosed as a teenager, he says he didn’t think much about it at the time—except for one key detail.

“I remember one book I was given to read; it was written 10 or 12 years before, during the ’60s, but it said the expected life expectancy of a newly diagnosed diabetic is 30 to 40 years after the diagnosis,” Nossaman says. “So, I was really good at math, and that meant between 48 and 58, I would be dead.”

For a teenager, it seemed like a lifetime away.

“It wasn’t until I got closer and closer, and I realized technology had changed, and my blood sugars were well controlled, that I was going to outlive that. I was going to prove them false,” Nossaman smiles. Today he is almost 65 years old.

Insulin and Sugar-Free Ice Cream

Nossaman was one of the thousands of children diagnosed with Type 1 diabetes in the 1960s and 1970s; diagnoses have steadily increased in the decades since. Type 1 diabetes is a chronic autoimmune disease that anyone can be diagnosed with at any age, though it often is first recognized during childhood or adolescence. For a person living with Type 1 diabetes, their body’s immune system attacks the insulin-producing cells in the pancreas. Insulin is an essential hormone that helps the body turn food into energy, so people living with the disease must take insulin by injection or insulin pump to survive.

“When I was in the seventh grade, which was 1972, I started getting these migraine headaches,” Nossaman explains. “I was actually diagnosed as hypoglycemic, so Dr. Archer told me if I ate peanut butter crackers every time I started getting the visual auras, that might prevent the headache. So, we did that for a couple of years, and he would check my blood sugars periodically. Then, two years later, when I was 14, it reversed. My theory is, I had a pancreas that was malfunctioning when I was in the seventh grade, and then, it just konked out when I was in the ninth grade.”

Certain genes and a family history increase the likelihood of someone getting the disease. According to the nonprofit Breakthrough T1D, if a person has an immediate family member with Type 1 diabetes, the chances of developing the condition are one in 20, which is 15 times higher than the general population. But Nossaman didn’t have a family history of the disease. He hypothesizes that his onset was caused by an environmental factor—a virus.

“Type 1 diabetes, as far as I know, doesn’t run in my family,” he says. “It was suspected that I had something called roseola, and that could have triggered it.”

Some researchers believe certain viruses may target beta cells, and as the body’s immune response tries to fight the virus, it may accidentally attack and damage beta cells. Experts emphasize that Type 1 diabetes is not caused by diet, but changes in diet and exercise must take place to manage the disease. That wasn’t always easy for Nossaman growing up.

“I remember there was only one sugar-free ice cream,” he says. “My mom always cooked healthfully, but when I was in high school, the cafeteria workers made the best banana cream pie and homemade rolls, and yeah, I cheated a lot, and it didn’t seem to bother me, so I would cheat.” The cheating doesn’t work as well when a diabetic gets older. “The big paradigm shift was when I realized that there was instant gratification from eating dessert, but that feeling I had afterward lasted a lot longer. You have to realize you feel better without that sugar than with it,” he says.

That lightbulb moment has led to Nossaman living an admittedly regimented life.

“I eat pretty much the same thing for breakfast and for lunch — half a sandwich and some vegetables,” he says. “Dinner and going out to eat is the variable. Sometimes you get it right with the insulin dosage and sometimes you don’t, but even now, I’m almost 65, I think I’m going to live longer than most people, and it’s because I’ve lived a healthy life and eaten healthy foods.”

Technology and Triumph

Nossaman also credits significant changes in technology—ones like the insulin pump he’s had for 30 years, and the continuous glucose monitor that he added to his regimen several years ago. Couple that with software updates that allow the two technologies to communicate, and you’ve got a life-changing solution to disease management.

“It’s amazing. I pretty much have an artificial pancreas in my pocket,” he says. “I have to punch in the number of carbs that I’m going to eat in a meal, and the rest of the day, it’s gauging my blood sugar — giving me more or less insulin. If I don’t punch in enough, it’s going to give me more insulin as my blood sugar goes up and keep the highs and the lows more steady.”

Nossaman’s courageous triumph over the disease for half a century has garnered him recognition from the Joslin Diabetes Center, a leading diabetes care and research center in Boston. Joslin’s Medalist Program began in 1948 when they started awarding a medal to people who had lived with Type 1 diabetes for 25 years as an incentive to those who navigated the challenges of the disease. 

As people started living longer, healthier lives with diabetes, Joslin expanded the program and began awarding a 50-year bronze medal. Thousands of these medals have been given around the world to people thriving with diabetes—and now that number includes Nossaman.

“What interested me the most was not the medal, but the chance to be in a research study for people who have had diabetes for 50 years or longer,” he says. “I think they’re just trying to find out why some people live very healthy lives and why others don’t.”

He fully intends to expand his lifespan. “I plan to live into my 90s, going for the 80-year medal,” he laughs. “I don’t think I want the 100-year.” 

Meantime, he says he wants his healthy life to be an inspiration to his patients and to others who might be struggling with diabetes.

“At least I can empathize with them and share my experiences,” he says. “I usually tell people that diabetes wasn’t a curse for me. I mean, I may have thought it was when I was a teenager. I didn’t want to be different from anyone else—that was my biggest problem. It’s been more of a blessing because I can tell you right now that I’m not inherently a person who would eat a healthy diet or exercise a lot—I don’t think I come from that.”

Diabetes, however, has become a critical motivator for his actions, diet and healthy lifestyle. Nossaman recognizes the irony in that. “Sometimes you end up being healthier because of your affliction,” he says.