I have clear memories of all the stuff I had to go through when I was first diagnosed with Type-1 Diabetes. Since my older brother had a wide variety of illnesses, junk food and sugary snacks were never really a staple in my household anyway, but I remember that certain things took a dramatic change nonetheless. I was no longer allowed to drink juice whenever I wanted. I was subjected to frequent daily shots for insulin and finger pokes for blood glucose testing. It was a traumatic time for a 4-year old who hadn’t even had the opportunity to grab life by the horns.
The irony is that all the traumatic stuff is the only reason I’m still alive, even if some of it was misguided, wrong and in some ways caused more harm than good. Back in good ol’ 1982, carbohydrate counting wasn’t a thing at my hospital. Maybe if I had lived in a larger centre, there would have been better Diabetes education available. But in my hometown, there was a singular mantra when it came to the control of Diabetes: Don’t eat sugar! That was it. In tandem with a morning injection of short-term insulin and an evening injection of basal insulin, my blood was tested once a day before bed and I was good to go.
Yes, you read that right! My blood was only tested once a day. Quite a far cry from the dozen times I finger poke myself these days, or the Sensor Glucose readings I get from my pump every five minutes. Not to mention that my first glucometer was roughly the size and shape of a brick. (There’s an illustration of that glucometer in my previous post: When Diabetics Get High… (but not the way you think) But Diabetes therapy has come a long way from it’s beginning, when a person diagnosed with Type-1 Diabetes usually considered it a death sentence.
Pump therapy, along with carb-counting and exercise, have made the life of a Type-1 Diabetic easier by scores from what it previously was! As illustrated above, the first insulin pump was basically the size of a large backpack and included metal parts and was cumbersome and impractical. It looks like something Tony Stark developed in a cave. Would I use something like this today? Obviously not, but back in 1963 when Dr. Arnold Kadish designed it, it would prove to be the launching pad for an insulin therapy device that would be widely accepted.
Smaller versions were developed by others roughly a decade later and they started being developed with wearability and accessibility in mind. But it wouldn’t be until the early 2000’s that insulin pump therapy would catch on as a common thing. One of the main obstacles is the overall cost. Although I don’t remember the exact retail price of my most recent insulin pump, I do know that it ran to the tune of about $8,500. If I didn’t have benefits through my work, I wouldn’t be on pump therapy.
That’s without taking into consideration that a box of infusion sets runs at about $200/month, reservoirs are about $50/month and the CGM sensors are about $400/month, making for a lovely total of almost $1,000/month when you factor in the insulin and test strips and anything else I may not have mentioned. Is it any wonder why people without solid medical insurance can’t take proper care of themselves? But I digress…
My point is that Diabetes therapy follows the very same trends as modern electronics and technology. When computers started becoming a thing, the average computer took up an entire room that had to be temperature controlled. Imagine trying to play Candy Crush on one of those bastards? The concept of a “personal computer” didn’t take hold until the 1970’s and even then they were boxy, clunky, difficult to move around and were pretty limited in what they could do. Today, the average smart phone has more computing power than what astronauts originally used to land on the moon.
The same can be said for insulin pumps. What started out as a huge, boxy, metallic backpack has now become a small, inconspicuous 3-ounce plastic box. Smaller than most cell phones. And technology is just getting better and better. There are different aspects being developed, including an artificial pancreas going through clinical trials, which could be promising for the future of improved Diabetes control. Who knows, maybe we’ll reach a technology that will allow for the wearing of a simple “insulin patch,” like a nicotine patch, and forego injections and needles altogether! We’ll get there, eventually. But getting there is the obvious problem and as the old saying goes, the waiting is the hardest part. ☯