25 years of diabetes – are we making any progress?

By | 15 April, 2009
I couldn't find a picture of a cake with "25" on it. Sorry.

I couldn’t find a picture of a cake with “25” on it. Sorry.

When I was diagnosed with diabetes at the age of 4 in 1983 you put urine in a test tube and added some chemicals to make it change colour so you could get a rough idea of how much sugar was in your body. Blood testing strips were a huge step forward.

In 1989, at the age of 10 I moved from two injections a day with syringes onto this thing called a Novopen. It was a beautiful creation, like a top quality, brushed steel fountain pen but it contained insulin and had a needle on the end. It meant taking four injections a day, but it gave me flexibility – I had a full portion of fish and chips for the first time since my diagnosis. Previously, I wasn’t allowed so many carbs.

Over the years meters changed, I was delighted when the first five second meters came out – it used to take two minutes to get a blood test result, now it was almost instantaneous. My pen changed from the beautiful original to a bigger, cheaper, plastic model that I whinged constantly about but made no actual difference to my care.

The bad old days

We got faster acting insulin. The insulin analogues – like Humalog and Novorapid – came onto the scene and meant that you didn’t fly quite so high for quite so long if, like me, you didn’t think it was very practical to have to inject before you’d even got to the restaurant, never mind seen the menu.

The long acting insulins got better too. Lantus came along, lasting for roughly 24 hours rather than the not quite so handy 18-ish hours if  you were lucky that Ultratard gave me.

We’ve even seen developments in the way care is delivered. Now we have courses to help people understand diabetes and more importantly how to live with it rather than be controlled by it. The medical profession recognises the role of the expert patient, and although paternalism is still alive and well in many hospitals, there is an increasing recognition that the patient does sometimes know what they’re talking about. More work to do here I feel.

So, we’re chugging along, seeing incremental improvements, but I don’t think there’s been anything that’s really changed the course of how we live with diabetes. I’m talking about something that completely changes the way we deal with diabetes – the equivalent of the mobile phone, iPod or the PC out in the real world.

The Internet has made a big difference in terms of having access to huge volumes of information and other people living with the same condition, but it wasn’t a diabetic specific invention.

Continuous glucose monitoring systems

For me, the biggest leap forward was in 2007 when I started using a combined insulin pump and continuous glucose monitoring system. The insulin pump infuses insulin at a steady rate throughout the day and I press a button to deliver more insulin if I eat or need to correct a high blood sugar.

I never wanted a pump, I didn’t see the point in them and I certainly didn’t want to be attached to something. I’ve had it for twoyears and wish I’d got one years ago. It gives me the ability to make sm all adjustments to my insulin delivery whenever I want to.

On top of that, my marvellous little machine has a continuous glucose monitoring system (CGMS) built into it. I wear a small sensor -usually in my back – that I change every seven days. That sensor monitors the level of glucose in my interstitial fluid (the fluid just beneath your skin) and wirelessly transmits the results to my pump. I can’t tell you how excited my techie geek husband is to have a wirelessly enabled wife!

More next time on the wonders and irritants of using a CGMS.  In the meantime, I think I’m using the nearest thing we’ve had to a diabetic technology breakthrough that’s made it into the mainstream but what do you think? What have been the great leaps forward in diabetes care for you?

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