17th century diabetics. Possibly.
I’m currently reading Michael Bliss’s excellent book “The Discovery of Insulin” (a full review coming soon, book fans!) which is a genuinely fascinating and sometimes thrilling account of insulin’s discovery and its path to mass-production. As someone with Type One it’s been very interesting and occasionally thoughtful look at the major breakthrough insulin undoubtedly was.
In 17th century England diabetes was known as “the pissing evile” (I think it should still be called this) and until the early 1920’s was completely incurable. A diagnosis of diabetes was a sentence of slow, inevitable death – with life expectancy for us Type Ones reckoned to be about a year or two at most.
Prior to the work carried out by Banting, Best et al in Toronto the best medical science could come up with was a diet pretty much free from carbohydrates. Dr Frederick Allan was the most well known advocate of this starvation diet and patients would be reduced to an intake of as little as 750 calories a day. In comparison we usually cram about 2,500 down our necks most days. Diabetics were reduced to living skeletons, but at least they survived, for a while.
Without treatment, the diabetic body would be unable to metabolise carbohydrates properly and in the later stages fats and proteins couldn’t be dealt with either, after which the victim’s system became clogged with partially burned fatty acids known as ketone bodies, which we occasionally test for if we can be bothered.
When large amounts of ketones were detected, doctors knew the patient didn’t have long to live. The patient would then fall into semi-consciousness and the lungs would heave desperately to expel the by-product of ketosis – carbonic acid in the form of carbon dioxide, with the victim taking great gasps of air known at the time as “air hunger” or “internal suffocation”. Thankfully, perhaps, a deep diabetic coma would follow, closely tailed by a merciful death.
Apologies for the lack of hilarious gags in this post, but as a Type One I found the descriptions of pre-1922 diabetics utterly horrifying. It was a lingering, unpleasant death that was equally unsatisfying for the medical profession to treat, as there was literally nothing they could do to put off the inevitable past a year or two.
Reading these chapters put my diabetes into perspective somewhat. When I was first diagnosed I had a few months of, to be honest, fairly mild suffering. I did feel ill with the classic symptoms, but I didn’t lose so much weight I clocked in at less than 100 pounds and comas were certainly never a realistic possibility.
As we all know, diabetes nowadays has its highs and lows – both physically and metaphorically. But I find remembering that pre-1922 it led to a lingering death both sobering and positive. So maybe that 10.3 reading doesn’t seem so awful after all.