Michael Hoskins and the Diabetes-Mine team have published a new blog about my early years with diabetes.
Great article, @Richard157! One thing caught my eye. Your description of the old Lente one-shot-per-day insulin is very vivid, and then you mention that:
In the 1990’s I started using a Humalog mix, and carb counting. I had a meter for testing my blood sugar at home.
Were you on R/N in the period between those two regimens?
Yes, I did use R&N for several years back then.
My experience was similar, Lente once per day in 1960-70s, NPH/REG 1980-90s. Then started using pump with Regular prior to Humalog/Novolog availability and switching to ‘human’ insulin when it was available.
Let me ask this question to T1’s of the 80-90’s or older.
How was your blood sugar control back then?
How often do you test?
What A1C were you getting?
I asked because I’ve been curious how the regimen a person started on influences their attitude toward the various regimens later on. For instance, people who started out on basal-bolus MDI often describe transitioning to a pump as life changing, and many are adamant about how much they loathe pens, injections and everything associated with MDI. For me that whole template shifts back one treatment regimen. After 20 yrs on R/N, which I started out on, I experienced MDI as a life-changing release from prison, compared to which transitioning to a pump was a good but merely incremental improvement (actually kind of a PITA at first); I still harbor nothing but positive feelings about MDI, and it’s R/N that’s the Great Satan, the mere mention of which fills me with a nameless horror.
So I’ve been really curious how R/N seemed to those of us who started out on Lente, which I missed by a few years. I was kind of missing hearing something about it in @Richard157’s account.
Mediocre to lousy, over the 20 yrs before MDI. I actually don’t remember any A1Cs from early on, back in the pre-glucometer days. I do remember occasionally lapsing and doing things like having a chocolate milk shake, which is kind of inconceivable to me now*. In the middle period, after glucometers came along, I remember getting yelled at a lot about not testing, not keeping enough data, and leaving my appointment with my Dr and I feeling pretty good if my A1C tested in the 7s.
Pre-glucometer, we had those color-strip things you compared against the patches on the container, so testing wasn’t quite the PITA that it had been a few years earlier, but it was still pretty crude. With R/N corrections weren’t really doable unless you were seriously out of whack–I can remember doing it when I was over 300–and bolusing for meal carbs wasn’t a thing at all. So I maybe tested 2-3 times a day when I was feeling conscientious. And writing it down in my little notebook, which I might actually do in the week or so leading up to an appointment with my Dr (I didn’t see a specialist for that 20 yrs). Somewhere after the first ten years or so I did start getting more rigorous–glucometers helped a lot–and by the time I finally got in to see a specialist I think I was mostly hitting low 7s. My first appt with a real endo at Joslin, he said “You’re not doing too bad considering your treatment doesn’t make any goddamn sense,” and promptly wrote me a prescription for Lantus, Novolog, and carb-counting classes.
*ETA: I should point out that I’d just turned 28 when I was dx’d; if I’d been a kid this sort of thing would have been much more frequent I’m sure!
Thanks for the eye-opening historical recount of your diabetic old-style control @DrBB . We need to see this to appreciate what we have today. Also a triumph for those who have survived the old conditions, given the crude tools they had. It brings a smile from me thinking now, of the criticisms we make of the available technologies.
3 posts were split to a new topic: Terry Story
This blog from DiabetesMine had no central theme, it was very broad in scope, so I don’t mind that we are comparing our past histories. I am enjoying reading them.
To @DrBB and @arpida_seru, my history started in the 1940’s and I have very little memory of my insulin types back then. I do remember Lente once per day, but was that my regimen for the 1940’s, or later? I’m not sure. That was 72 years ago! For some reason, I remember seeing “protamine-zinc” written on my vials at one time or another. Do any of you remember that? Was that an addition to Lente?
I have no idea how high my blood sugar was back then, but when I started BG testing with a glucometer 40 years after being diagnosed, BG’s in the 200’s were commonly seen. Some 300’s, too. There were hypos at night as well, so my control was a major roller coaster experience, but I persevered and actually thrived. So did many of my Joslin friends from back then.
I tested 12-15 times per day in the 1990’s, but did not start pumping until 2007. My A1c’s started in 1980, and were so good by the 1990’s that I did not see a reason for pumping then. Friends in DiabetesDaily group convinced me to try using a pump in 2007. It made things so much better, and I wished I had started pumping in 1990 when my doctor suggested that I do so. My A1c’s were originally in a chart online, but a friend in England made a graph for me. (See below.)
With a pump and CGM I am still testing about 8 times per day. There are times that my meter and CGM differ as much as 10-20 points, so I need to test every time I am going to bolus, and at bedtime
In 1985-95, my endo would send me a letter after each A1C, which included a graph of past results, and a picture of a thermometer to show the most recent value. In earlier tests, the thermometer shows 9 and below as good to excellent, above 9-15, labeled “need help”.
But then later, after DCCT, the good to excellent range moved to 7.5 and below.
I also made a spreadsheet and graph of my A1Cs, and included in my Joslin 50 year medal application. It looked very similar to yours.
Before 1985 I didn’t keep records, but estimated my A1Cs in 10-14 range while using once/day injections of Lente.
Nice article… Good Read
Well done, Richard!..Judith…