Living with diabetes blog

Diabetes then and now

By Nancy Klobassa Davidson, R.N. and Peggy Moreland, R.N., C.D.E. December 22, 2009

I recently watched an older movie on YouTube titled "Glory Enough for All" that gave me a new appreciation for the diabetes treatment options we have today.

In the past, a diabetes diagnosis diabetes meant wasting away to certain death in a year or two. Just 100 years ago, I would have lost two sons to diabetes. Until the 20th century, diabetes mellitus or "honeyed" diabetes was diagnosed by tasting the patient's urine for sweetness. Then things began to change.

  • By the early 20th century, Dr. Frederick Allen prescribed low calorie diets that restricted patients to 450 calories per day. It prolonged the lives of some people with diabetes a year or two.
  • In 1921, a young Canadian surgeon, Frederick Banting, and his assistant, Charles Best, kept a diabetic dog alive for 70 days by injecting it with a concoction of canine pancreas extract. With the help of other doctors, a more refined extract of insulin was given to a young boy dying of diabetes. His blood sugar dropped to within normal limits within 24 hours. This was truly a miraculous discovery. Elizabeth Hughes, one of the first children to be treated with insulin, lived to be 74 years old.

Medical breakthroughs have continued to prolong the lives of people with diabetes.

  • In 1935, Roger Hinsworth discovered two types of diabetes — "insulin sensitive" and "insulin insensitive" — that further opened up new avenues of treatment. Also in the mid-1930s, pork/beef insulin and longer acting PZT insulins were marketed.
  • The 1950s brought oral medications called sulfonylureas that were introduced to better manage blood sugars for those with type 2 diabetes.
  • In the early 1960s, urine test strips were developed to test blood sugar. People with diabetes no longer had to use test tubes and tablets and wait for results. In 1969, the first blood glucose meter was developed.

Dr. Richard Bernstein, who had type 1 diabetes, describes his first meter: "In October of 1969, I came across an advertisement for a new device to help emergency rooms distinguish between unconscious diabetics and unconscious drunks when the laboratories were closed at night. The instrument had a four inch galvanometer with a jeweled bearing, weighed three pounds, and cost $650."

One day, he arrived for a meeting at his attorney's office. He said he was carrying his meter in a bag and hung it up in the coat room. A few minutes later everyone was in a panic as they thought it was a bomb. The 24-story building was evacuated. He had a time convincing the bomb squad it was his glucose meter! Thankfully, today's meters fit in your purse or pocket.

Insulin pumps are about the size of a pager and can easily be carried in a pocket or clipped to a belt. The A1c test that was devised in 1979 provided a more precise blood glucose measurement — hemoglobin is used to track glucose changes over a period of 3-4 months. Other type 2 oral diabetes medications and rapid acting insulin have been added in the last 15 years. 

What will the future hold? What would you like to see?

Dec. 22, 2009