Are we spoiled?

Are we spoiled?

An interesting question has been poised this week, not really in that way, but that is the essence of the question. The real topic being explored is what has been accomplished? Like I said it is really a being posed as a dual edge discussion what has been accomplished and given all that has been accomplished are we spoiled?

So let’s look at the first part of that question. What has been accomplished? The answer is more than anyone could have reasonable predicted even in the 1990’s. Here are a few accomplishments:

1. Standard measure for units of insulin,
2. At home testing for blood sugar,
3. Almost universal availability of effective type 2 drugs,
4. A heavy emphasis on developing new type 2 drugs,
5. Insulin pumps,
6. Sterile syringes, and
7. The rise of Endocrinology and Certified Diabetic Educator as professions

The thing is every one of those accomplishments is in and of themselves revolutionary. Take for instance the standard measure of insulin units. Do we realize there was a day prior to 1950 that one unit of insulin depended on which insulin manufacture we used and which syringe we had? We hear the common complaint today that diabetes is really a math problem. I agree that diabetes is a math problem, especially for those who use a syringe for control. Today we first determine the amount of carb being consumed then they convert that too insulin units to administer. However, toss in calculations for the insulin being used and the syringe (as done in pre 1950) and you have something akin to a calculus problem at the dinner table. Without standardization we would not have carb based insulin dosing and likely no insulin pumps, or if we did we have to choose the pump based starkly on insulin availability, something that many of us know changes often.

How about the recent emphasis on type 2 drugs? Wow what a turn around. The new drugs being developed are remarkable both for their diversity of approach and the sheer number of new products. I entered the search term type 2 drugs. I got a list of over 100 drugs available for treating type 2 Diabetes. Several of these drugs are not commonly used, but many (about 15) are first line drugs. I cannot think of many chronic diseases with more options for treatment than are available for type 2 diabetes. This is a stark difference from the 1990’s when the main prescription for type 2 diabetics was to eat less. We have come a long way in a short time, That doesn’t mean we have done enough, but compared to where we were in the 1990’s we are so much better off.

How about sterile plastic syringes? We have several people in our community who will remember the problems with sterilizing syringes between uses. What a mess. The invention of plastic disposal syringes has led to the development of the pump, universal access to insulin and thin gauge smaller needles. Sterile single use disposable syringes were a technical revolution like few others for people with diabetes. It is a remarkable accomplishment we take for granted today. Yet in its day it completely revolutionized care of diabetes. If you take multiple daily injections, you do so because of sterile disposable syringes. Without sterile disposable syringes few could have that treatment option. Without multiple daily injections it is doubtful a pump would have ever been approved.

All this come to the unsaid point of the look back efforts. Are we spoiled? Well yes I would say we are. We are spoiled because we (me included) take these innovations for granted today. We want more innovation and we want it quicker. But, we often fail to remember how far we have come and the struggles we had getting here. It is a remarkable journey we have been on. So much ground has been covered, but it has taken a long time. Our innovations are small steps on a long road. We all want a big breakthrough and we all seem to define success differently. I can guarantee that in its day uniform insulin units seemed a far off goal. Today we hardly remember that was ever an issue.

Perhaps our lesson is that we need to celebrate our small successes. Each small success is like a brick being added to a path. Think of that path being the ultimate cure for diabetes. No one could have ever built the path all at once. Instead it will be built one brick at a time. So are we spoiled? I know I am. I often fail to give thanks for the things already accomplished. I just have to remind myself that the path to the cure will be built one brick at a time. It will take all the bricks, even the ones that ultimately lead nowhere, to build the path that will get us to the cure. We also have to remember the term cure is a moving target. My cure is likely your milestone and vice versa. It pays to remember the milestones while we push forward.



I wouldn't say spoiled, but I would say fortunate in the history of ailments.

Hi Rick, nice blog! Here's an article about (5)how far we've come with pumps. I used to use one and loved it, but in time I ran out of real estate. Darn.

As for (6) sterile syringes, I'm grateful for them. I'm on MDI; I use 1/2 unit syringes to remove the insulin from my Apidra and Levemir pens. During the day I take shots for basal, meals, snacks, corrections, and of course, finger-sticks for testing. That probably adds up to 18 pokes daily altogether. At the end of the day I'd like to be grateful, but more likely I'm worn down and worn out. I'm still watching for advances, though--I suspect some PWDs would say the CGM is one.

I don't think that we are spoiled one bit, without a doubt we are fortunate that advancements continue to be made in the treatment of both T1D and T2D. These changes/improvements do make our life that much easier to achieve a certain level of normality, but spoiled I think not. Now if all of these tools and medications were provided free of charge then I would probably change my point of view concerning the being spoiled aspect of this great disease called diabetes. I would have to say that the ones that a truly spoiled in this whole epidemic and treatment there of are of course the pharmaceutical companies. Please don't get me wrong I do really appreciate all the hard work that goes into coming out with advancements towards a almost worry free regime for the treatment of diabetes, but at what cost to those who have the disease. When I think back to 1973 I do not remember it being so complicated, for some reason it seemed so easy. The day would start off with taking one syringe, yes it was made of glass and to top it off the needle was freaking long and thick too. Now days its either 4 to 5 injections with a fast acting and a basal insulin or the pump route then testing 10 to 15 times a day or CGM. Plus now with the new finds over the last 15 to 20 years our cholesterol and blood pressure needs to be below the norm it just never seems to end when it comes to the cost to maintain the life of a diabetic, so spoiled I think not. Sorry for the rambling on and any errors I may have made in my little blurb, I love being a diabetic but I'm not spoiled. Cheers.......

I like this blog rick. And I remember where we have come from with U-40 lente insulin and clinitest tabs to check urine glucose levels. I'm grateful for the new devices and technology which helps me manage my blood sugars but I don't agree I am spoiled. D is not the kind of thing you can just put on the back shelf and care about when you feel like it. D requires you to pay attention all the time. Personally I would appreciate a complete vacation from D and let someone or something else do the thinking for me. I too would choose the word fortunate.

I agree, Rick, that it's easy to lose sight of the tremendous advances we've made in diabetes treatments. The level of control I exert on my daily blood glucose levels was not possible even 10 years ago. The fingerstick meters, insulin pumps, rapid acting analog insulins, CGM technology, and now the ultra rapid acting insulin, Afrezza, all contribute to help me control my diabetes better than ever. On top of that I can communicate with fellow members of my tribe day and night, a breakthrough and advantage that continues to amaze me.

Rick, I’m thinking not spoiled. That phase makes me think of people who just kick back & are catered to. None of us PWD are spoiled or catered to. We all work hard everyday. But I will say I’m very grateful for how far we have come. Not fond memories of my little chemistry lab in the bathroom or that 1 ■■■■ a day, injecting blindly as we had no idea what was going on. Grateful for all the new tech that makes it easier to fix those highs & lows. I will put myself in the spoiled category when we have that promised cure in 5 years. Just very thankful for all the tools I have today vs 44 years ago.

Spoiled? No....I think not. Technology, as you have said Rick, has evolved by leaps and bounds! It boggles the mind thinking what advancements in diabetes care (and in the care of other chronic conditions) will be made in just the next decade! Not a hundred years ago, diabetes was a sure death sentence. I know you are smiling ear to ear Drs Banting and Best. Spoiled? No....thankful? BEYOND WORDS!