Diabetes used to be easy

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Image source: (c) Staples

When old people (39=old) reflect on our life’s experiences, we tend to harken back to “the good old days”.  Back when life was easier, and time moved slower.

We had a choice of seven TV channels.

It took at least three days to transmit written words from one coast to the other.

Dialing a phone number (especially if the area code was a toll-free “800”) meant moving the little wheel back and forth…back and forth… over and over.

Re-heating last night’s dinner took about half an hour in the oven.

The good old days.

Insulin durations were measured in hours, not minutes. Hardly anyone used a pump.

Blood glucose levels were always one of the following: 20, 40, 80, 120, 180, 240, 400, 800 mg/dl. If you had a keen color perception, you could guesstimate something in between.

Insulin dosages were prescribed by the doctor and were always the same: X units of regular, Y units of NPH. One set of X-Y’s before breakfast, and another before dinner.

In the ’80s, after school I would go out and ride my bike around the neighborhood – or perhaps in the woods behind the elementary school. Sometimes I’d plan to meet friends beforehand, other times I’d venture out alone and see who I might run into. I carried a small box of raisins in my pocket in case I began to feel “weak”. That feeling was my gauge.

Hypoglycemic unawareness wasn’t a “thing” yet, because average blood sugars were much higher than today’s “normal” range. There was no published DCCT study, and “intensive therapy” was not yet the law of the land.

These days, when I read blog posts by parents of kids with diabetes, it’s a whole different ballgame. Parents keep their kids on much closer watch: texting, calling, and emailing their food, blood sugar (even CGM trends), and insulin dosages back and forth all day. They have to.

I only took two shots a day.

There were plenty of eat-overs, sleep-overs, and birthday parties at friends’ houses. They were no big deal; I took my prescribed insulin and ate my prescribed food (and rebelliously some extra), and all was good.

The whole reason I’m bringing this up is because Christina’s excellent post on Friday got my brain working in high-gear, drawing comparisons to my own childhood.

No, I don’t fault her one bit for making sure her daughter would have responsible, watchful eyes looking over her, and that they would know what to look for and how to respond “just in case…”.  If I were in her shoes, I would do the exact same thing.

The. Exact. Same. Thing.

That’s the downside of the “intensive therapy” we now strive for — of the tightly-controlled and as-close-to-normal blood sugars we work so hard to achieve. With a target A1C in the 6’s or 7’s, rather than in the 8’s or 9’s, the “normal” is lowered, so the “lower-than-normal” becomes more dangerous. Likewise, with pumps replacing Lantus, Levemir, and NPH, a severe DKA scenario can happen quicker than ever.

We need to be more vigilant than ever.

The “old way” of doing things wasn’t healthy. Nor was following an exchange-diet easy. A life with A1Cs in the teens can’t sustain itself too well. And, despite keeping my blood sugars much higher back then, I probably averaged one 911-hypoglycemia emergency per year.

It’s been about ten years since my last one of those.

I often look back at my younger years and wonder how I made it. I did — somehow — but I wouldn’t recommend it.

I’m better off as I am now — with carb counting, frequent blood sugar testing, and everything else that goes along with so-called “intensive therapy”.

But it sure seemed easier back then…

* * *

I hope this post does not come across as judgmental or critical, I certainly did not write it to seem this way. It’s just my observation that it seems so much harder to care for a child with diabetes today than it did thirty years ago. That being said, I’m sure my parents took plenty of precautions behind-the-scenes that I didn’t know about, but it was nowhere near today’s standards. Technology wasn’t that advanced.

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Posted on April 9, 2013, in Diabetes, Personal. Bookmark the permalink. 7 Comments.

  1. at a JDRF session, one D-elder was saying that SHE grew up without any of these tecno-D-things and SHE was fine. This was a peppy, athletic octogenarian. But the *other* D-octogenarians…weren’t there. Out snowboarding? Confined to home? Who knows.

    It’s just like you say…whatever’s available, we sort if have to use or at least try.

    That’s cute with the raisins. I do that with Smarties. (But also: meter-pump-CGM.)

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  2. Scott, I think about this all the time. I can’t get over how many sleepovers, cross-country trips and just normal daily living was done with just a few blood sugar checks throughout the day (I was dx in 1995). I just took my insulin with my meals and never thought TWICE about low or high blood sugars. I had part-time jobs, babysat, etc. etc. However, when I review old lab work my A1cs were always at least high 7s or worse, so of course I was never thinking about low bloods sugars because they rarely happened!

    I’d take today’s d-management over anything from the past, but I miss the ignorance we all had.

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  3. I can’t speak for anyone else, but it’s as if you knew what’s been rattling around in my head. I think back and don’t remember having 3am checks except in the hospital. I lived in France for a summer two years after I was diagnosed. All sorts of stuff that make me wonder “what the hell was I thinking?” But like you, the Reg + NPH regimen didn’t send me spiraling up or down quite so quickly. I didn’t think of the “immediate life and death” that a lot of us with intensive regimens talk about now.
    We did have it easier. Healthier? Nah. Did it hurt any less or made us feel less guilty? Nah. I’m glad we have the tech now, but I think it’s harder on the parents and kids today.

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  4. Scott–I think about this often as well. I was diagnosed in 1985 (at 18 months old) and didn’t get a pump until December 1999. I can remember being on the NPH/Regular schedule you talk about here, then the “sliding scale” with regular and Humalog. I remember going from 1 to 2 shots a day, then eventually a 3rd shot of Humalog at dinner. At one point my endo suggested we try a lunch time shot of Humalog as well, and my mom (who is a T1D as well) just flat out said no–we aren’t dealing with shots at school. I read some of the D-parent blogs today and can’t even imagine any of them just saying “eh, we don’t want to take more shots–too bad”. But back then, my mom said no and the endo just said OK, no big deal. Wow! Can’t imagine it now! I never tried Lantus or anything–just went from NPH to a pump. But I never took more than 3 injections a day unless my BG was SUPER high (like over 400). Oh, you’re 275 at 2:30 in the afternoon–that sucks. Why don’t you just let that one ride until your dinnertime shot, okay? Crazy to think of it now, but you’re right–it was so much easier then, and I could actually feel my lows!

    I read a blog post from a D-parent a few months ago where the mom talked about having to educate her child’s teachers about operating a pump. The teachers were actually responsible for giving the kid boluses for lunch and snacks. It would suck to be a teacher with that kind of responsibility, but good for those particular teachers for stepping up!

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    • It’s incredible to hear about giving teachers, or even nurses, responsibility over insulin, isn’t it! In my day, they only treated lows…all the insulin came at home.

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  5. Your post comes off beautifully, in my opinion. It’s something I think about often, too. Things were so much less micro-managed back then.

    It’s difficult for all of us, today. But that difficulty is magnified for all of those amazing d-parents out there. They have my everlasting respect for all they do.

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