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March 14, 2013
The other day, a relative e-mailed me an article highlighting the results of a study involving Type 1 diabetes. The study found that the average life expectancy for people with Type 1 diabetes was no longer significantly different than that of the average person. In fact, in just the last 40 years, the average life expectancy for someone with Type 1 has increased by an average of 15 years.
The study suggested that advances in the technology of diabetes care have contributed to this trend in very significant ways. Looking back on my experiences over the past 19 years, I tend to agree. Personal blood glucose monitors were readily available when I started on insulin 19 years ago. But fast-acting insulin had not yet become available. Pumps were in their infancy, still clumsy and only reserved for severely brittle cases of diabetes. Strict meal plans on strict schedules were still the norm — carbohydrate counting would have to wait for the advent of fast-acting insulin.
During those first five years of living with diabetes, I saw the entire paradigm for disease management shift. It shifted, in my opinion, not so much with the advancement of the pump, but with the adoption of fast-acting insulin. After all, it was fast-acting insulin that really made the pump an effective tool, able to respond quickly to changes in blood glucose. And for those of us who chose to stick with daily shots (no pun intended there), fast-acting insulin completely changed the game.
I went from adhering to my strict, preset meal schedule to the flexibility of carbohydrate-counting, matching my insulin to my food instead of matching my food to my insulin. This allowed a level of freedom and flexibility I hadn’t had before. And it allowed for quicker corrections, as well. Before fast-acting insulin came around, bringing down a high number was a matter of hours. With fast-acting, it became a matter of a half hour. Unexpected deviations could be accounted for — traveling became easier, going out with friends became easier, family gatherings became easier.
But fast-acting insulin was only the beginning. Like I said, the fast-acting insulin allowed pumps to become infinitely better at controlling insulin levels, and this brought about a revolution in care for millions of people who had been unable to control their glucose levels on injections. And while the technology involved in checking blood glucose didn’t change all that much, advances in computing power turned our meters from simple blood-checkers to real monitoring systems. Meters could be connected to home computers, and the readings could be put into graphs, charts, and tables. We could e-mail our doctors these readouts for advice instead of waiting three months for our next appointments.
The explosion of the Internet meant we could network, sharing solutions to common problems faced by people with diabetes. Recipes could be found easily; calorie and nutrition information could be searched for anytime. Now in the age of smartphones, we can download apps that can give us the carbohydrate count for almost any menu item in most of the nation’s major chain restaurants. The information we need to successfully manage our disease is readily available, 24 hours a day.
While the breakneck speed of the modern world can be a drain sometimes, and the stress of it can cause problems for those of us managing a chronic disease like diabetes, the proliferation of information and staggering increase in technological ability are tremendous gifts.
It makes me wonder where we’ll be 20 years from now. Like many people with Type 1 diabetes, I try to avoid thinking about the miracle of a cure. I have diabetes, and so I need to live with it. Spending time fantasizing about what it would be like to live without it is counterproductive. But even if we fall short of a cure, the day-to-day challenge of managing this disease will continue to improve. Continuous blood glucose monitors are already out there. Right now, they’re rare, and the technology hasn’t evolved. But that’s exactly how people talked about pumps when I was first diagnosed, and look at them now. In 20 years, continuous blood glucose monitors may be the norm. An artificial pancreas — a pump connected to a continuous blood glucose monitor able to intelligently manage blood glucose through it’s own feedback loop — may be a reality.
Seeing that study gives me hope. It gives me hope to know that children given this diagnosis today don’t have to face some of the challenges that I faced, just as I never had to face some of the monumental challenges faced by the generation before me. We are progressing, we are moving forward. We don’t have a cure yet, but that isn’t stopping us from pushing forward and improving our lives.
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