Wednesday, May 17, 2006
Twenty-one years since the diagnosis and I'm in kind of a reflective mood. I'm thinking about what has improved during the intervening years, what's actually worse and what could do with a huge upgrade.
In 1985 Type 1 diabetes was called Juvenile Diabetes or Insulin Dependent Diabetes (IDD) and pork and beef insulin was still being prescribed. But a growing number of people were taking the new "human" insulin, many of whom I seem to recall, blamed it for loss of hypo warning signs. When I was diagnosed, I was more concerned that the human insulin didn't come from actual humans, and when I was reassured that it was manufactured, that I got that rather than animal insulin (I was a recovering vegetarian at that time).
I was taught to use a syringe and told I could either mix the basal Ultratard with the bolus Actrapid or shoot it on its own before bedtime. As I was so befuddled I couldn't cope with mixing the stuff (hugely complicated), I opted for four rather than three shots a day. A little while later I discovered the diabetic nurse (that's the nurse who worked with diabetics and who had juvenile diabetes) used a Novopen and I had to have one. Before I left the office, please.
There was some sort of deal with the purchase of a special meter, buy one get a Novopen free (plus ça change, plus c'est la meme chose), so I got a cool Novopen, and I loved it. Everyone thought it was a real pen and people were upset when I told them they could not borrow it. Still it was three shots of Actrapid and one of Ultratard and though I've changed insulins I'm still shooting up at least four times a day. This definitely needs improving.
Eventually the Novopen was replaced by Novopen II, nasty, plasticky beige but with one great feature: you could take your shot and the number remained displayed until you used the pen again. So if you were on a sliding scale and were the forgetful type you could see if you had taken your shot or not. In those days I had to take the shot 30 mins before a meal and I could forget a lot of things in that half-hour. Unfortunately the plastic locking mechanism wasn't very sturdy and the pens broke easily. A few years later and U-40 insulin became U-100 and I had to swap to a Novopen III. That was upgraded and it no longer showed the last number dialed, so I now had to remember if I had had a shot or not. Definitely worse.
Now I have disposable Humalog pens. They are so ugly, much bigger than they need be and no-one is going to mistake them for a Bic. Plus, I feel I'm using up the earth's resources at an alarming rate. What happens to all that plastic?
As for meters, I'm on my fourth. I loved my Glucoscan II so much. It had a huge display, 30 second wait compared to 60 seconds of other meters, it was simple to use, and was slim. It sat in a vinyl wallet, strips on one side in their foil packages, meter, lancets and sticker on the other side. Looked great, worked great.
When it finally died, my parents bought be the AccuCheck meter and I hated that machine with a passion. It was truly the worst designed meter I have ever seen, the size of a brick and an unappetizing generic grey colour. The strips came in a tube and I could never get the top off. I either had to ask someone to help or I wrestle it off with a knife and end up with strips all over the floor and, once or twice, a nasty gash to my finger. It was also so complicated and gave so many false readings I went out and bought myself a new One Touch Ultra.
The improvement here was a five second wait for results and it was tiny. But it didn't do much else. Then the big upgrade to One Touch UltraSmart. I know I've complained about this meter elsewhere, largely because it isn't Mac compatible but there is the facility to record insulin intake and carbs, fats, protein; it gives weekly, monthly and three-monthly averages, it even lets you record doctors' appointments.
What I'd like now is a meter that has a better screen, that comes with a keyboard so I can type in additional information and that wirelessly interfaces with my Mac. Manufacturers are you listening?
I remember the endocrinologist coming to see me while I was in the hospital and telling me two things: it was the best time in history to be diagnosed with diabetes and that there would be a cure within the next ten to twenty years. Well, I think he may have been right on the first one, and a lot of things have got better, especially the advocacy and activism and support of other people with diabetes but as for the second, I'm celebrating twenty-one relatively healthy years living with diabetes but I don't see that a cure is any nearer now than it was then.