Aidan

Back in July 1977, when I was first diagnosed at the age of 14, people seemed to be optimistic about an imminent cure for Type 1 diabetes. Maybe they were just trying to cheer me up. Stem-cell research will at some stage have an impact, I suppose. Insulin injection accessories and blood testing have both improved immensly over the last 41 years.

When I arrived home to County Waterford from St Finbarr's hospital in Cork after my diagnosis, my family were fascinated with my having to boil my stainless steel/glass syringes in a saucepan of water every few days, and keep them stored in special containers immersed in methylated spirits. Drawing up the two insulins from their respective bottles (the long-acting basal and the fast-acting prandial insulin) involved attaching wide-guage green needles to each syringe to draw the two insulins out of their respective bottles. Then these needles were detached and a narrow gauge orange needle was attached for the first injection of the fast-acting insulin half an inch under the skin. Then that syringe was detached from the needle while leaving the needle still inserted under ones skin. The second syringe of long-acting insulin was then attached to the needle for the second dose before withdrawing the needle and swabbing the skin with a lump of cotton wool soaked in methylated spirits. Insulin volumes were very large compared with those today, and there was always a visible lump in the skin after an injection. The syringe needle was much longer and thicker than the ones on the insulin pens nowadays and the injections usually hurt a bit. Insulin was administered twice a day, before breakfast and before the evening meal. The tricky part of each day was between 10.30am and 1pm when one had to get food to coincide with the insulin activity peaks resulting from the pre-breakfast injection. This was the most risky time of day for a hypo. Nevertheless, hypo symptoms were generally strong and gave plenty warning - something to do with the nature of the animal-derived insulins used at the time, I think. These were replaced by human genetically-engineered insulin in 1983, which unfortunately had more subtle hypo symptoms in my experience.

In the early days, I was lucky to have a supply of single-use disposable needles, thanks to a benevolent local GP - and within a few months, even got prescribed disposable individually-wrapped syringes that had their own needles attached. With these, insulin was drawn from both bottles into the same syringe with the same needle as used for injecting. As I found out later, many Irish patients in the early 70s had to repeatedly sterilise and reuse blunt needles. Insulin pens were introduced in Cork in 1993 and the only significant change since then has been the introduction of more concentrated and faster-acting insulins and insulin analogues in 2006.

Personal blood-testing started to appear from 1985 onwards and initially involved using a big meter and rinsing off the blood from the strip with water before sticking the strip into the instrument to take the reading. Prior to then, urine testing was the only way to get an indication of ones blood-sugar levels. Testing meters and strips became more like today’s from about 1990 onwards, and it was only from that time that I took up frequent blood testing leading to better control. Looking back, my control had been poor, sometimes bordering on dangerous, from the ages of about 16 to my late 20s.

Regarding food, the Type-1 diabetic diet is fundamentally a healthy one. I gave up sugar, sweets and deserts after I was diagnosed; and while it was difficult initially as a teenager, I got used to it and generally adhered to it apart from frequently taking advantage of hypos to consume sweet things. The introduction of aspartame-sweetened fizzy drinks (sugar-free Coke, 7-Up etc) in the early 1980s was liberating.

Nowadays, I pen-inject insulin and test blood sugars multiple times a day, frequently taking small corrective doses of insulin after food/drink to keep the blood-sugar level as close as possible to normal. Participating in the Berger programme in 2011 was very insightful and made good control at lot easier.

Diabetes has never held me back in any way and I’m still free of health complications. I worked on the family farm as a teenager, later went to university, joined a band while I was still a postgraduate student in the late 1980s (playing all over the world for over 6 years) before settling into an academic career and having a family. Good diabetic control is far easier today than it ever has has been.