The Evolution of Diabetes Products

Management from diagnosis to today from a 40+ year person with diabetes.

By Scott K. Scolnick, M.Ed.

Diabetes is one of those strange things in life. None of us went to bed one night and thought, “you know what might be a cool thing to add to my life?  Diabetes! I need something that requires my attention every single day with no vacation.  And I want to add something that costs a lot of money, has an impact of every aspect of my life, and best of all, no matter how hard I work, I don’t get paid a dime for my efforts!”

None of us asked for this, but we woke up one day and our lives were changed forever. I have learned, sometimes the hard way, the more I think I know, the less I know.  Every day, every meal, blood sugar, work out, stressful situation and unknown or untested life situation only adds to this thing we call life with diabetes.

One thing I do know is if you are going to have diabetes, this is the best time. In all my 41 plus years having lived with diabetes, I have never seen so many incredible innovations. When I meet people who have more time in the “club” (as I like to refer to it) I marvel at the stories of them needing to boil their glass syringes and sharpen their needles on a file. In one respect, I was lucky.

When I was diagnosed in 1975, this was the state-of-the-art treatment. First off there were disposable syringes with huge, thick needles, and we used either beef or pork, long acting and short acting insulin.  I was 15 when I joined our club and this next step was one of the toughest parts of diabetes – measuring my sugar.

To see what my “sugar” was, I had to urinate in a cup. I would take an eye dropper and fill it with urine, count out 10 drops of into a test tube, clean out the eye dropper with water and then count out 5 drops of water.  Now the real fun began.  I would take a tablet out of the vial and drop it in the test tube.  Warning!  You couldn’t hold the bottom of the test tube, because it got hot!  Believe me, there were many a times when I dropped a test tube filled with urine on the bathroom floor.  Let your imagination take it where it may…

After a set number of seconds, we would have to hold the test tube up to a color scale on the vial of tabs. What we were checking for was the point at which we spill glucose into our urinary tract, but each of us has a different point.  If I had to get my “sugar” down quickly, the fastest acting insulin didn’t start working for at least 30 minutes.  We really didn’t know what our blood sugar was or how to figure out how much regular insulin to take.

Insulin: From animal to human. From slow to fast acting.

In 1980, I decided to become a vegetarian, except of course for the either beef or pork insulin I had to take.  Thankfully, in 1982, Lily developed a human synthetic insulin.  The insulin quality got better, but we still did not have a fast acting insulin.  Humalog became available in 1996.  This was a huge breakthrough as was the addition of a 24-hour basal insulin, Lantus, in 2001.  Throughout this time, other insulin companies came out with similar insulins and the competition has been a very good thing for people using insulin to treat their diabetes.

The Diabetic Diet

When it came to our diet, it was painful. We had to eat around the action times and peaks of our insulin.  Every day it was the same thing.  I followed this regimen much of time, but I never liked it.  I was a sophomore in high school after all!  There were so many “exchanges” I had to eat.  Exchanges amounted to proteins, fats, starches, and milk.  I have never liked milk which was a new set of hurdles for me.  Next was the mid-morning snack, followed by lunch; a midafternoon snack; dinner, and a bedtime snack.  All the while, we had to eat these meals at pretty much the same time every single day, including weekends.  I was a teenager who could not sleep in.

Long gone are those dreaded exchanges.  I learned to count carbs around the same time as Humalog came out in 1996.  For the first time in my diabetes life, I could take the insulin I needed to match the food I was about to enjoy.  This changed my relationship with food for the better.  I could enjoy a plate of pasta, a couple slices of pizza, or potato chips.

I now had a tool to try to keep my blood sugar in check.  One of my favorite activities these days is to go out to dinner with a group of my friends with diabetes.  We immerse ourselves in the experience and we ask each other “how many grams of carb do you think?”  I call this exercise, the old “spray and pray.”  I take the amount of insulin I think I need, keep checking my blood sugar about every hour or so and hope I made the right decision.  Checking my blood glucose along the way is an important tool as I can take corrective action and learn from what I did and either do the same if it worked, or alter it if it didn’t.  Every meal and every time we check our blood sugar is a teachable moment.

The Immense Evolution of Measuring Glucose

The first at home blood glucose meters came out in 1981.  It was huge and it took a lot of blood and a long time to get a result.  However, progress is progress.  At first, we had to lance ourselves with what seemed to me at the time, a miniature spear.  We needed a huge sample of blood.

The next evolution were lancing devices.  Some of my friends and I (no so fondly) called it “the guillotine.”   This was an experience many of us can’t easily forget.  You would load a lancet into this device, seen below, and pull back the spring-loaded device.  You would place your finger underneath the opening and press the button and watch as the lancet pierced your skin. Again, it was progress.

How things have changed!

We now have lancing devices where we can barely feel the prick. We have blood glucose meters which need .3 ml of blood and can read our results in a matter of seconds. This is to say nothing of the improved accuracy of these meters.  There are meters which communicate with smart phones and can even send alerts out to loved ones and family members in times of crisis.  We can email our health care professionals the data from our meters right from our phones or home computers. We, at Dario, strive to make managing diabetes as simple, safe, and easy as possible.

We now live in an interactive and connected world which includes the one thing we don’t get a break from: diabetes.

My parting words to you are to embrace this technology. By doing so, we can live healthier, more productive and longer lives enriching our families and our communities.  As I have read, we don’t have a choice about having diabetes, but we do have a choice about how we choose to manage it.