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  • With Mayo Clinic diabetes educators

    Nancy Klobassa Davidson, R.N., and Peggy Moreland, R.N.

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  • Living with diabetes blog

  • Dec. 22, 2009

    Diabetes then and now

    By Nancy Klobassa Davidson, R.N., and Peggy Moreland, R.N.

24 comments posted

I recently watched an older movie on YouTube titled "Glory Enough for All" that gave me a new appreciation for the diabetes treatment options we have today.

In the past, a diabetes diagnosis diabetes meant wasting away to certain death in a year or two. Just 100 years ago, I would have lost two sons to diabetes. Until the 20th century, diabetes mellitus or "honeyed" diabetes was diagnosed by tasting the patient's urine for sweetness. Then things began to change.

  • By the early 20th century, Dr. Frederick Allen prescribed low calorie diets that restricted patients to 450 calories per day. It prolonged the lives of some people with diabetes a year or two.
  • In 1921, a young Canadian surgeon, Frederick Banting, and his assistant, Charles Best, kept a diabetic dog alive for 70 days by injecting it with a concoction of canine pancreas extract. With the help of other doctors, a more refined extract of insulin was given to a young boy dying of diabetes. His blood sugar dropped to within normal limits within 24 hours. This was truly a miraculous discovery. Elizabeth Hughes, one of the first children to be treated with insulin, lived to be 74 years old.

Medical breakthroughs have continued to prolong the lives of people with diabetes.

  • In 1935, Roger Hinsworth discovered two types of diabetes — "insulin sensitive" and "insulin insensitive" — that further opened up new avenues of treatment. Also in the mid-1930s, pork/beef insulin and longer acting PZT insulins were marketed.
  • The 1950s brought oral medications called sulfonylureas that were introduced to better manage blood sugars for those with type 2 diabetes.
  • In the early 1960s, urine test strips were developed to test blood sugar. People with diabetes no longer had to use test tubes and tablets and wait for results. In 1969, the first blood glucose meter was developed.

Dr. Richard Bernstein, who had type 1 diabetes, describes his first meter: "In October of 1969, I came across an advertisement for a new device to help emergency rooms distinguish between unconscious diabetics and unconscious drunks when the laboratories were closed at night. The instrument had a four inch galvanometer with a jeweled bearing, weighed three pounds, and cost $650."

One day, he arrived for a meeting at his attorney's office. He said he was carrying his meter in a bag and hung it up in the coat room. A few minutes later everyone was in a panic as they thought it was a bomb. The 24-story building was evacuated. He had a time convincing the bomb squad it was his glucose meter! Thankfully, today's meters fit in your purse or pocket.

Insulin pumps are about the size of a pager and can easily be carried in a pocket or clipped to a belt. The A1c test that was devised in 1979 provided a more precise blood glucose measurement — hemoglobin is used to track glucose changes over a period of 3-4 months. Other type 2 oral diabetes medications and rapid acting insulin have been added in the last 15 years. 

What will the future hold? What would you like to see?

24 comments posted

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  • May 14, 2012 5:34 a.m.

    Since they no longer make pork and beef insulin in America, my son and many other diabetics have to import the pork and beef insulin from England and Canada.

    - Pam

  • October 13, 2011 11:05 a.m.

    I WOULD LIKE TO SEE A TIME WHEN A PILL CAN BE DEVELOPED THAT CAN BE TAKEN IN LIEU OF INJECTED INSULIN.

    - AL

  • December 15, 2010 1:15 p.m.

    I was diagnosed in 1976, and I had to test my blood sugar levels using my urine with a test tube and tablets. This article indicates that they were done away with in the 1960s! My brother and I, among many others especially at camp, used this method for years.. into the early '80s. thankfully the needles got thinner and thinner over the years. I've been on an insulin pump for close to 2 years now and LOVE it! I'd prick my finger for blood *any day* over what others have to go through for their illnesses. If it hurts, you need to adjust the level of your spring action on the lancer and / or use the side of your finger tip, not directly on the tip itself.

    - Stacey

  • September 13, 2010 2:57 p.m.

    Can anyone (authors included) expand on the claim that in "1935, Roger Hinsworth discovered two types of diabetes — 'insulin sensitive' and 'insulin insensitive'?" There are several websites with similar claims, written in a conspicuously similar fashion, but not one provides a reference. This statement and description ring strikingly closely to the work of Harold Himsworth, who wrote of the distinction between insulin sensitive and insulin insensitive diabetes mellitus in 1936, as well as the novel idea of peripheral insulin insensitivity. (The Lancet, v. 227, i.5864, p.127-130)

    - Rob

  • July 17, 2010 5:00 p.m.

    Beyond doubt, the best way to avoid type 2 diabetes, particularly if you are in a high risk group, is to eat sensibly and take regular exercise.

    - Jonny

  • July 16, 2010 6:56 p.m.

    But research has found that those with abdominal fat are more at risk of type 2 diabetes. The fat around the abdomen gives one an "apple" shape, and is referred to as abdominal obesity. The fat in this area is called visceral fat, and has been found to cause insulin resistance, unlike the subcutaneous fat under the skin in the rest of the body.

    - Adams

  • May 25, 2010 3:10 a.m.

    I would like to see monitoring glucose without finger stick. It really hurts.

    - Song

  • January 26, 2010 1:54 p.m.

    Jerry, there are home testing A1c monitors available on the market. Check out the diabetes magazines.

    - Nancy and Peggy

  • January 26, 2010 1:52 p.m.

    Jamie, It sounds like the up dated Omnipod will be smaller and the pod will be sensor ready in the future.

    - Nancy and Peggy

  • January 19, 2010 10:51 a.m.

    I would like to see an OmniPod like device that also has a continuous glucose monitoring system in it, so that one would not have to wear 2 different units, and it could be managed with one device.

    - Jamie

  • January 18, 2010 8:11 p.m.

    As a wife and mother of diabetics for the last 56 years. I can sure vouch for all the inprovements in the care and treatments. We always want better care, but if you have gone throught all the changes I have, you would be very thankful for the advances that have been made. A bid THANK YOU to all the resurchers.

    - Gloria

  • January 17, 2010 12:52 p.m.

    Above all, a cure. My 26yr. old daughter has been insulin dep. since age 9. I pray everyday that she and others with this chronic disease will see the hour when it is no more.

    - Sue

  • January 15, 2010 6:30 a.m.

    I would like to see a A1c test developed just like the diabetes testing that is used today.

    - Jerry

  • January 15, 2010 3:22 a.m.

    Which Gastric Bypass surgery if any do you recommend to a patient with type 2 diabetes and high blood pressure? I'm intrested in the Sleeve because of the non re-route of organs and no loss of nutriant and calorie absorption. I'm considered Morbid Obease by my BMI. My goal is to loose weight only because I want to be healthier. I don't want a surgery that will potentially contribute to my existing health conditions and not assist in resolving them. Thank You

    - Ms Shelton

  • January 14, 2010 6:53 p.m.

    An insuling pump which can be worn as a watch and monitor glucose levels. My pump is impossible when I werar a bathing suit! Of course I am thankful EVEYDAY that we have what we have. Can't imagine how I survived, testing my urine using a test tube at age 7.

    - B

  • January 14, 2010 1:57 p.m.

    Wish the constant glucose monitoring devises were better than they are right now. My son doesn't mind injections at all...just wants good control so being able to constantly see where BG levels are would be great especially at school. We went to a class on CGM...but my 13 year old whispered to me, "Not interested!" He just didn't like how it is attached to your body. Too bad they didn't have something that doubled as a watch and CGM. Mostly...I hope for a cure! The work at Wake Forest (spinning blood and creating heart valves) makes me hopeful that SOON we will see artificial pancreas grown from DNA spun from blood. Never say never! There is the optimist in me that thinks some morning I will wake up and hear on the news something simple right under our noses can be eaten and it regenerates the pancreas...THAT would be awesome! Ya never know!

    - Mary

  • January 14, 2010 1:24 p.m.

    As a father of a son that just got diagnosed 14 days ago with Type I, I am encourged by articles such as this one.

    - don

  • January 14, 2010 12:51 p.m.

    While I wait for a true cure, I would LOVE to see the artificial pancreas widely available and extremely reliable with in the next couple years. I would also like to have a glucose meter that you can use elsewhere on the body that doesn't have the delay because of the interstitial fluid. Although my 5 year doesn't mind the pokes I can see the marks on his finger tips.

    - Pam

  • January 14, 2010 12:41 p.m.

    Of course I'd like to see a cure, but in the meantime, I'd like to see a continuous glucose monitor that communicates automatically with the insulin pump to control blood glucose. Or better yet, one device that performs both functions with only one site.

    - D

  • January 3, 2010 1:48 a.m.

    I would like to see some real world technology like we see in the movies. Like in the movie Panic Room, the little girl has a device that looks like a watch that monitors her blood glucose levels continuously and activates an alarm when it goes out of ideal range. Something like that would be an enormous leap forward for glucose level control.

    - Samantha

  • December 28, 2009 6:18 p.m.

    of cource a cure, in which the other cell organ rather than pancrease secreate insulin

    - AS

  • December 23, 2009 10:38 p.m.

    A shot of stem cells every 10 years

    - Ed

  • December 22, 2009 11:28 p.m.

    Very grateful that I was not diagnosed with Type 2 until 2007 as I have been so wonderfully supported (we live in Australia) in my efforts to regain my health. Last time I followed up a recall notice the new clinic MD asked me why I was there....then he said very gravely, it seems as though you might be borderline diabetic....otherwise your health is great....Needless to say I took it as a compliment although concerned with the office record keeping.

    - Ellen

  • December 22, 2009 8:17 p.m.

    Of course, a cure. Oral insulin and glucose test with out the finger poke.

    - John

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