A Dose of Reality
June 13th, 2007 by Steve(Continuing on from my inaugural blog post…)
Later, after I became an adult, my mom confided in me that she thought I would be dead within a year. That was a reflection of how diabetes was (circa 1966) and sadly still is understood both here and across the world. There are still many places in this world where a diagnosis of type 1 diabetes is a death sentence. My doctor, a very nice pediatrician who was very involved in the care of my condition, started me on a single dose of Lente insulin, which I remained on for the next 15 years with some occasional adjustments.
We only had urine testing for sugar in those days. Lots of colors to look at! 
Of course this is still not an uncommon practice: to be followed by a non-diabetes specialist, that is.
Fact: 80% of all persons with diabetes today are cared for by general practitioners, family doctors, internists or pediatricians. There are just too many of us to each see a diabetes specialist all the time. And our numbers are growing every day!
My parents gave me the majority of my injections. My dad was a better shot-giver than my mom. He would get up every morning, boil the re-usable 25 gauge needle, a glass syringe and its plunger in a tea strainer for 15 minutes, and then lay it out to cool. After drawing up the dose, he would come to my room (I was often still asleep), and wake me up to give me my insulin injection in the hip, arm, or leg. I’d roll back over a few minutes, and then start getting ready for the day. This was a 30 minute process, start to finish… except when the glass plunger locked up. (That’s another story for another post!).
Fact: Today, insulin dosing can be done in seconds!
Embedded in the above paragraphs are three actions that were key to why I did so well with, by today’s standards, with so little:
#1 - I had two caring parents who devoted themselves to making sure I got what I needed to stay healthy, at least by 1960’s standards.
#2 - Responsible adults (my folks) played an active role in the key elements of my care: my dad with the injections (most of the time) and my mom with my meal planning (we were given a sheet of do’s and don’ts).
#3 - They kept me on schedule (a virtue for any person self-managing their diabetes, or their child’s diabetes).
Tune in next time to read what happens as little Stevie goes to College 
Last 5 posts by Steve
- Day 15 - Sixtieth Camp Blog Entry - August 3rd, 2008
- Day 13 - Fifty-Ninth Camp Blog Entry - August 1st, 2008
- Day 12 - Fifty-Eighth Camp Blog Entry - July 31st, 2008
- Day 11 - Fifty-Seventh Camp Blog Entry - July 30th, 2008
- Day 11 - Fifty-Sixth Camp Blog Entry - July 30th, 2008
June 14th, 2007 at 7:44 am
I think many of us can relate to the virtues of what early management was like, although truth be told, I seem to recall Clinitest urine sample results having a different range of colors (maybe 5-6) which ranged from orange at the high-end of things to blue at the low-end of things (I remember 0, +, ++, +++, and ++++, brilliantly scientific)! Having relived memory lane, let me say that I do believe that what many newly diagnosed patients believe (and indeed, are told) is that we grew up in the dark ages of diabetes care, yet there are a number of valuable lessons that today’s patients never get. First, timing does matter even if you are on a flexible regimen because predictability in eating, activity and insulin dosage does work! Second, we did not have the idea that we can eat pretty much whatever we want as long as its covered with insulin, a dose of common sense would go a long way towards the way newly diagnosed patients manage things. Finally, by avoiding excessive junk foods, it not only prevents gaining weight, but it also reduces the total daily dosage required, all of which have great benefits that seem lost on many newly diagnosed patients today.
June 14th, 2007 at 8:35 am
Coming Soon - the ‘All You Can Eat Pump’.
A lot of pwd, and I suppose a large number of educators and physicians, are guilty of letting insulin to cover carbs play backup to better food choices. Having a dietitian as a key member of your team is something I think a lot of pwd don’t get and should.
June 14th, 2007 at 10:28 am
I agree with Scott. The relative strictness of our lives in those early years did create a kid of internal consistency we don’t see as much of today. The trade off for a “near-normal lifestyle” may include some of our glycemic control in the process.
June 14th, 2007 at 10:49 am
Even though I was diagnosed later (in 1986), I can remember relying on color charts instead of concrete numbers as my blood glucose management tools. Technology has come quite a long way in my twenty+ years with type 1.
But I agree - freedom gained from these technological advances can sometimes lead to a higher deviation.
June 17th, 2007 at 8:02 pm
I apologize for the color chart. It was certainly not as above. Deep blue (negative), blue-green (trace), green, and a green-orange, then finally bright orange (4+), I will never forget! That chart just gives a flavor of what it was about, I know. Like most of you that know this, I had a bunch of map colors that I and my parents used, along with a grid made with a ruler in an Aladdin notebook to color in the different Clinitest results. I have all this stuff in my office (my mom didn’t throw any of it away) and I display the glass syringes in a case in my waiting room (along with eyetone meter, old pumps and everything in-between!).
Regarding the urine tests, as I look at my original records, it is interesting to see the honeymoon phase kick in as the colors all turned deep blue (negative, the “good” color, huh?) and stayed there a few weeks, before gradually starting to change to green, and later bright orange (Yikes! 4+, high values!). Fewer folks will appreciate these references. It’s always good to know where you came from to give you a sense of appreciation for where you are now, isn’t it?
June 17th, 2007 at 10:37 pm
Check out our Barbara Anderson’s comments on cnn.com tonight (June 17th) regarding “diabulimia”.
http://www.cnn.com/2007/HEALTH/conditions/06/17/diabetes.bulimia.ap/index.html
This is a seriously underappreciated problem that I see in my practice very often. Up to one in three adults with type 1 diabetes OMIT insulin for weight control. Barbara is one of the world’s experts on this condition. Her recent data on follow up of teen girls and young adult women with this condition shows that many of these persons are seriously disabled (blind) or even dead 11 years later. The message is: don’t ignore insulin omission. Most girls DON’T outgrow it! This requires a concerted effort on the part of the family (and the person with diabetes) to seek help ASAP from experienced health care providers and eating disorder specialists with an appreciation of the nuances of type 1 diabetes!