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Living with diabetes

Ralph and Joan Koenig of Dickinson understand the challenges of living with diabetes.

Diagnosed with type 1 diabetes at age 17, Ralph has experienced many of the complications of the disease including eye damage, loss of teeth and amputation of a big toe.

However, the Koenigs also appreciate the improvements of living with diabetes because of research.

"There's a great need -- we need every penny we can get for research," Joan said.

For that reason, they are helping to promote the Eagles Auxiliary 5K walk/run for diabetes research on Saturday.

Ralph won't be participating because he walks with a leg prosthesis. He lost the lower left leg through a work-related accident. Joan, who works as a 911 dispatcher, will walk if she gets a little sleep the day before.

Ralph was in high school when he was diagnosed with diabetes.

Type 1 diabetes results from the autoimmune destruction of insulin-producing beta cells of the pancreas. The lack of insulin leads to increased blood and urine glucose. Untreated, type 1 diabetes can be fatal, but the disease can be controlled with supplemental insulin.

Ralph received a kidney-pancreas transplant in November 1999.

"In the year prior to the transplant, I was in the hospital off and on," he said. "I felt terrible and I was ready to give it up."

He also was on peritoneal dialysis at home for more than three years. With the process, he was hooked up to a machine to remove impurities from the peritoneal fluids from 7 p.m. until 8 a.m. the next morning.

"He was insulin-free for six years and then became a type 2 diabetic," Joan said. "His body wasn't able to utilize the insulin that the pancreas produced."

Through the years, Ralph has gone through laser surgeries for his eyes, wounds that refused to heal and the need for dentures. Ralph also has had three heart attacks, and last February he went through open-heart surgery.

"It eats away your body slowing and continuously," Ralph said. "You don't heal when you get cuts and bruises and sores take forever to heal."

He pointed to the toe that needed to be removed. He recently concluded months of wound care at a Billings hospital.

The Koenigs chose Billings because a daughter lives there and they also have a farm and ranch near Baker, Mont.

Ralph recently returned from Billings, Mont., where he was fitted with a new prosthesis. It allows him to work normally on the ranch. He leased the farm land and pasture, but continues to take care of the cattle.

At age 57, he said, "I can't just sit around."

Today, the transplanted kidney continues to work perfectly.

"We will never be able to thank his donor family for what they've given us," Joan said.

"I've had my ups and downs since the transplant, like the open-heart surgery, but I feel really good again," Ralph said.

"God has been good to us," Joan added. "We've had many miracles in the 38 years we're married."

Ralph offered several words of advice to newly diagnosed diabetics: Exercise and watch your diet.

"Keep very good control -- don't cheat," added Joan. "You may think nothing happens, but 10 years from now, the damage will show up and you can't reverse it."

Ralph continues to monitor his blood sugars and takes insulin four times a day. He said he's not a candidate for an insulin pump because his level of activity varies greatly from day to day.

"It's funny, but when we have get-togethers, anything with sugar tastes terrible to me -- it's too sweet," Ralph said. "I never drank much pop, not even diet pop. I drink mostly water and coffee."

The Koenigs encourage everyone to support the walk-run for diabetes research.

"Diabetes is a silent killer," Joan said.

"A cure needs to be found," Ralph added.