We didn't have all of these sugar-free choices in sodas, or nutritional labels with carbohydrates and fats listed. All we had was Tab or Fresca, and that was it! To this day if I see a Fresca I will buy it, just for the fond childhood memories. (Tab was for the girls.)
And we tried to guess at "starch exchanges" rather than carb-counting, which was just fine because we took two daily shots of pork Ultralente and Regular (mixed in one syringe) so even if we somehow knew the carbohydrates it didn't make a difference anyway because we took the same shots that we always took at the same time each day, and tried to eat no more or less than the exchange diet some dietitian put together at the hospital. The dietitians were intent on starving us, too. For lunch we could have 3 bread exchanges, 1 meat exchange, 1 fat exchange, and 2 fruit exchanges, which was a sandwich, a half-glass of milk and 12 grapes. And you were done, unless you were hungry and wanted to snack on a 'zero exchange' snack like cabbage or celery sticks. These dietitians still seemed to subscribe to the Joslin method of diabetes management from the era before the 1930s, when persons with diabetes were slowly starved to death so that they wouldn't die from DKA.
There was no adjusting our dosage, or programming correction boluses, because we used Clinitest tablets or strips to test urine for sugar levels. This was a remarkable technological advance! There were two readings - negative, or "trace." If it was trace, we had better pull out a ketstix, pee on it and hope we weren't spilling ketones. And if the first test was "negative," well, that meant our blood-glucose level was anywhere between 40 and 200, but 45 minutes ago. There were no basal profiles and different basal rates to account for the "dawn effect." Because we were busy peeing on sticks that told us nothing, we didn't even know there was a dawn effect. We didn't know what we were correcting, and the Regular insulin didn't really peak for about 4 hours anyway. By that time we were peeing in a plastic cup and getting ready for another Ultralente/Regular shot, and salivating at the prospect of dinner, which allowed us to have 4 (that's right, four) meat exchanges! That was about 2 plain, medium-sized chicken breasts. Oh, the delight we took in being able to eat more than one exchange of anything, then washing it down with a Fresca.


Point being - I'm not asking for sympathy, I just want the newly diagnosed kids to stop and consider what it was like only 30 years ago before complaining about how hard diabetes is. Goodness, I feel like Rosa Parks tsk-tsking a modern hip hop artist: "Do you even know where we started?" Yes, diabetes is still hard to manage today, and we should continue to push, but know your history first. Back in my day, it was worse.

Views: 12

Tags: Clinitest, diet, exchange, exchanges, history

Comment by Samantha on January 30, 2009 at 10:06pm
It's all sorta relative though isn't it? Not disagreeing with you and I need to hear something like this once in a while to keep my whining to a minimum. My 2 months of D have been hell. But, for different reasons. My own private hell is knowing how bad it was back then and not really knowing what is happening with me now.

Doc says: Take these pills, they'll make your body produce more insulin.
I says: How do you know I don't produce enough insulin?
Doc says: Just take them and see what happens, we'll adjust in 3 months, make an appt on your way out.
I says: Can't you run a C-peptide? I heard about this and would prefer knowing how my body is breaking down and treat that and not take pot shots.
Doc says: Not necessary.
I says: Why don't we find out if I need to produce more insulin before we make me and waste time and my insulin production?
Doc says: I'll see you in 3 months.
Now, this is a bit of an exageration (sp?) but basically how it went.

Difference is back then, the docs were just learning as well. Now-a-days they should know but don't want to teach us or use the technologies. I could go into the health insurance issues and all that as well but then I would truly be whining. I just think the frustrations are different now.

By the way, I am sooo grateful that I was diagnosed in 2009 and not 1975!
Comment by Greg on January 31, 2009 at 9:22am
Interesting point. Maybe the growth in research, treatments, technology, alternative therapies and pharmaceuticals has overwhelmed some medical professionals. Back then there were fewer options for Type 1's, just a standard regimen.
Comment by Kathy on January 31, 2009 at 4:20pm
Oh yeah.
I was dx'd as a teenager in '74. I remember the dietician coming to my hospital room with "the booklet". She was talking about exchanges and I told her I didn't like milk. She said "well, that's going to change - you will drink 3 glasses a day". (No, the two of us did not connect.) But, she was working with all she knew at the time.
I left the hospital with instx to take 66 units of nph each morning. No one explained to me that nph has a prominent peak and the larger the dose the higher the peak. I didn't know what was happening to me each afternoon. Yes, they had spoken to me briefly about hypos, but when I asked the doc how it would feel, he just said "shakey".
Tab and Fresca - yum - "one crazy calorie". And, do you remember the "pre-sweetened kook-aid" that tasted like it had iron filing mixed in?
Sigh...................so many changes. And, I would not go back to those days, even just to visit.
Comment by Greg on January 31, 2009 at 5:03pm
It scares me to think back to how few memories I have of hypoglycemic episodes. I must have been running a constant high for about 10 years. But until bg meters, how would we know?
I remember the sugar-free chocolate candies that my aunt bought for me at Easter or Halloween when I was little. I gobbled that stuff up, but of course I didn't relaize that it also had some carbs that would affect me. Worst of all, that sorbitol-based stuff didn't work well for me. Uhh, you know what I'm saying.
Comment by tracy on February 1, 2009 at 1:41pm
Interesting thread, Greg - I'm a T1 from 1971, so I hear ya!! BTW, I am a girl, and I drank BOTH Tab and Fresca. :-)
Regardless, I do think Samantha has a point - the disease itself is not easy, period. Many significant changes need to be made in lifestyles, regardless of diagnosis date. The state of the medical field currently (doctors/insurances/hopsitals/etc) can, & often does, bring up an entire new set of challenges & issues.
Samantha - can you request to see another doctor? Is the one you refer to an endocrinologist? Are you tied to this md by insurance? Can you get a referral to an endo by this md by being a "patient from hades" and demanding one? Could you just tell this md "I am sorry, but I know I need to see an endo. This issue will not be resolved between you & I without this step. Please refer me now." I do understand the frustration and worry this situation brings with it. Just remember - you are paying the physician for a service they are providing to you. If you & the doctor cannot attain/maintain a mutally beneficial scenario, it is a waste of both your time schedules to be there. if you cansay this non-threateningly, with a gentle voice, perhaps you will be able to get a refferral/reach a resolution with this doctor. Let us know how it goes for you!
Comment by Samantha on February 2, 2009 at 4:52am
By the way - I was a totally Fresca girl even though I was not plagued then.

Tracy, I have to play the waiting game right now with the insurance which is an HMO. My Primary Care Physician is very nice but I do not like their politics in the office. Silly things like they will not fax me my test results, I have to call and leave a message and in 3-5 business days they will call me and let me know when I can pick up my copy for a charge of $15. And, when I decided to double my dose of meds one morning and hit 45 mg/dl there is no one to call and talk to! Their solution in go to the hospital for everything.

I have one more referral to the opthalmologist and after that appt. I can change everyone. I just wish there was a real way to interview doctors without having to make appt's and paying the co-pay to find out you don't fit.

Just frustrating is all. I know the technolgy is there to find out more detailed what is happening but I think a lot of the newly diagnosed still remain in the dark when they don't need to.

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