A Look into the Diabetes Dark Ages

Posted by kelly on Wed, 01/28/2015 - 18:10 in

I’m incredibly grateful to have access to diabetes technology and my current and future health has directly benefited from said technology. Diabetes technology isn’t always perfect and there are moments that I complain about it, LOUDLY, and there have been moments where I’ve come close to throwing my D-technology against the wall or out the window! Do I want quicker turnaround times for diabetes technologies and scientific breakthroughs?  You bet I do and I’ll absolutely fight for those technologies and scientific breakthroughs! BUT, I’ll never take diabetes-related technology/breakthroughs for granted, because I remember when diabetes technology (if you can even call it that) was downright archaic.

I was diagnosed with diabetes 37 years ago, at the tail end of the "Diabetes Dark Ages", and it wasn’t easy. Back in 1977, the diabetes exchange diet was incredibly strict and inflexible. The ADA Exchange Diet poster hung from our kitchen wall (and directly behind my seat at the kitchen table) so that we could refer to and follow the exchanges to a T. Twelve grapes equaled one serving. A serving of strawberries was 1 cup and orange juice was 1/2 a cup. Most veggies were free foods, as were pickles and diet Jell-O. Baked potatoes were not a free food and were either small in size or served in halves, never wholes. Same goes for bananas.

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Diabetes and food became all about measurements and amounts - which isn’t a normal way for anyone to think about food. Diet JELL-O and pudding were dessert norms and really special occasions meant rainbow sherbet, except of course on my birthday, when I was allowed birthday cake, but only one slice. Counting carbs and insulin sliding scales weren’t around in the 70s and 80s, but I wish they had been!

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How Checking Blood Sugar Used to Work

Back then there was also no such thing as glucose meters or continuous glucose monitors (CGMs). Nope, back in the Diabetes Dark Ages we tested urine instead of blood. And it was pretty darn gross. The bathrooms doubled as science labs in the Kunik household.  The perimeters of our sinks and the back of our toilets were lined with glass test tubes sitting in their racks, and directly next to those racks sat a brown glass bottle of blue Clinitest® tablets. Those tablets fizzed a rainbow of colors when you mixed it with five drops of urine and 10 drops of water in a test tube. The glass test tubes became so incredibly hot as the Clinitest® tablet bubbled and fizzed that you could burn the tips of your fingers as you waited for the color that represented your “sugar” to be revealed.

Here’s a breakdown of how it all worked:

  • Blue=  Negative and meant that all was right in your world.
  • Teal Green=  Trace and it was darn near as good as blue and became my go-to color of choice.
  • Green Bean Green=  1% and wasn’t considered a “bad” result at all.
  • Putrid Green=  2% and I still get slightly stressed out whenever I see that color on the pantone chart.
  • Putrid Brown=  3% was a cause for panic and you could cut the tension with a knife.
  • Orange=  5% and meant both danger and non-compliance all rolled into one.

The “portable” version of Clinitest® tablets was called Tes-Tape®. Yep, it was portable, but it was no more accurate than then the Clinitest® color scale, which wasn’t really accurate at all.

Insulin Delivery

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By the time I was diagnosed, syringes had been upgraded from glass ones, that required boiling before every use for sterilization and sharpening by hand, to plastic disposable ones that that were far from their “ultra-fine” counterparts available today. Of course some habits die hard and my parents still boiled the plastic syringes in a little brown pot on the stove every time one of us needed to take our insulin. They would carefully remove the needles with the same tongs we used to flip bacon and that little light tan pot with the dark brown handle rarely left the stovetop.

The insulin we put in those syringes had names like Regular, NPH and Lente. To this day the only thing I know about Lente was that my dad used it, while my sister and I were NPH girls. When glucose meters finally made an appearance a few years later, they were incredibly expensive, took four minutes to calibrate every time you tested and neither the meter nor the test strips were covered by insurance.

I have a very vivid memory of my parents, my older sister and me being led to the back room of a special durable medical equipment pharmacy and being taught how to operate the meter that came with a 50-page instruction book.  The pharmacist explained how everything worked and my parents took copious notes - and I remember my mother breathing a sigh of relief when the pharmacist said that we could cut the strips in thirds in order to make them last longer. I wanted nothing to do with our family’s glucose meter, because of the incredibly painful guillotine/harpoon lancing device that was necessary to actually draw the large amount of blood each strip, whole or cut into thirds, required.

Original Insulin Pumps

Insulin pumps, while in existence were the size of VHS tapes and weren’t readily available. For years I would hear rumors of the mystical and magical insulin pump, but never actually saw one until I graduated from college.

Lack of a Diabetes Community

The Diabetes Dark Ages weren’t only limited to the science and treatment of diabetes, they extended into methods of communication and community, or lack thereof. My parents were basically on their own when it came to a diabetes support system and I don’t know how they did it, because they were completely alone. Now that I’m an adult, I appreciate what they did for me and my siblings - and I wish they were both still here so I could tell them face to face, instead of in a blog post.

“Communication methods” with my endocrinologist involved my amazing mom writing all my numbers (sugars) along with descriptions and measurements of every meal, and physical activity before and after each meal, down on a yellow legal pad and calling my endo’s office every couple of days. Then, slowly and methodically, she’d read the results to the person on the other end of the line. Within a few hours, the endo’s office would call back with changes to my insulin requirements. Sometime in the mid-/late-80s, my father purchased a fax machine for his home office and we started faxing our numbers in.

As for me, my “diabetes community” consisted of two older children in my area with type 1 - we acknowledged one another from time to time, but we didn’t really hangout because they were three years older than me. There was also my neighbor, one block over and across the street, who was a teenager and type 1 when I was diagnosed. I remember whenever I came over to play with her younger sister, she was always nice to me and asked me if I wanted a diet soda. But if I hadn’t attended the long-since-gone Camp Firefly in Spring Mountain, PA for two weeks every summer for three years (grades 4th through 6th), I never would have met any children my own age with diabetes. That camp and those friendships changed my life for the better.

Diabetes Technology Today

Today, diabetes is a different ballgame and people with diabetes have choices when it comes to managing it: MDI (multiple daily injections), a vast array of insulin pumps, pens, glucose meters and continuous glucose monitors that can be accessed in the cloud and insulins that are genetically engineered to work smarter and faster.

We also have access to Certified Diabetes Educators who can teach us all the tricks of the diabetes trade and we have access to an incredible Diabetes Online Community (the DOC) where we can find support, strength and comfort from one another 24/7, 365 days a year. As people with diabetes (PWDS), we must remember the Diabetes Dark Ages, so we can appreciate our diabetes present while fighting for our future, which may or may not include diabetes.

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