You will have noticed the lack of posts on here. That is because there has been a lack of activity. And that is because all my mental concentration is currently taken up with other matters. I hope you will excuse the diversion off railways, but the impressive acceleration of engineering in medicine can sometimes be missed, but in one field, it is not missed by me.
For the record, I’m type 1 diabetic. I have been since I was 4 so I remember very little of my time before I was diabetic. By the age of 7 I was doing my own injections and couldn’t understand why that was such a big deal (I can now – give a hypodermic syringe to a seven year old??!!), by the time I was 11 I was on the “pen”, and now at the age of [insert what you think here] I’ve just gone on the pump.
I thought, therefore, I’d give a quick run down of some of the advancements in diabetic technology over that last 30 odd years.
When I started out in the diabetic world, insulin came from pigs, syringes and needles cost money (diabetics had to pay but drug addicts got them for free – work that one out), and a blood test was a guesstimate based on matching a stick to a coloured chart at exactly 2 minutes (and don’t leave it any longer). And to get that drop of blood for the test? You used this little beauty. Didn’t leave much to the imagination, and working on an arc, it didn’t so much prick your finger, as rip it (but only a teensy weensy little bit so that’s alright).
In 1984 (IIRC) the Government allowed type 1 diabetics to have free syringes so I came off the big ones with disposable needles and moved onto the “conventional” disposable syringe.
It wasn’t until the late 80s I got a meter to test my blood sugar. It didn’t do it any quicker than doing it manually so its only use was accuracy – you still had to faff about for 2 minutes trying to find out the result – and when your mates are outside playing in the 10 minute morning break, losing 20% of your time for a blood test seems really mean. It also used those weird 6v batteries that looked like a AA chopped in half. This photo is a good summing up of my day back then (I found another version of this picture on a French museum website – that’s right, my life now goes in museums).
In 1989 I went onto the Novopen. This was revolutionary back then, it being the first time you injected per meal (i.e. you changed the injection size to cope with what you ate), rather than doing injections in the morning and evening and then eating to suit. (The hangover from this understanding of diabetes can still be heard today – people saying “oh you can’t eat that, you’re diabetic”. “Actually I can eat just the same as you, and I will get just as fat as you will…”)
The first Novopen was the 1.5 and took 1.5ml cartridges – novel name!
The next was the Novopen 3 with 3ml cartridges…
After that, they gave up and went onto usual numbering so out came the 4 (which I did have) and the 5 (which I didn’t).
During this period the blood test meters got smaller and better too, with me finally having the Accu-chek Mobile which got rid of test strips completely and instead put the test paper on a cassette, and attached the finger prick (lancet) device onto the meter for ease of use. Present day meters also manage the test in about 5 – 7 seconds, which is a pretty good improvement on the previous 2 minutes.
My present mental concentration is taken up because I have, as of a week today, been on an insulin pump. In 1982, when I was diagnosed (now you can go back and do the maths), pumps did exist but they were on trial, and were the size of a backpack. Basically, a pump mimics a “normal” person’s body very closely, delivering a constant (but variable) stream of insulin in the background, and then working out, based on your blood glucose level, and the carbohydrates you’re eating, how much insulin you need for any given meal (and being able to deliver that insulin over the course of several hours if you’re having a low GI meal, or a long drawn out multi-course meal). Of course for this to work, you have to have a tube constantly attached to your body and you need to tell the pump what your carbohydrate intake is and what length of time you want the insulin delivered in, but it is much cleverer than the Mk1 human brain cell at working out what is thee right thing to do in a bout a second. This is as close to being a non-diabetic human a diabetic human currently gets.
The engineering that has gone into this is incredible, and means you are unlikely to notice I’m even wearing a pump. I deliberately went for the pump which comes with a touch screen blood glucose meter which controls the pump by Bluetooth so I never have to touch the pump when I’m out and about and it just looks like I’m playing with my phone – even t’missus isn’t sure which one I’m playing with half the time! (In the picture, the meter is on the left, the pump with clear plastic tubing to the body is on the right).
Getting it all set up when all the goal posts I have used for the last 30+ years have all moved all at once is challenging to say the least. Currently this is what I seem to spend a lot of my free time doing. The day will come when it’ll be properly set up and I can go back to doing other things, but currently all railway modelling is on hold.
As I said in an earlier post, I’m glad I didn’t say which Christmas I’d build Mini-me his railway for!
It’s interesting to look back now from my early days of being diabetic when it was still thought type 1 was caused by bad eating, when insulin came from an animal, when needles had to be bought, when diabetes could limit your lifestyle and you were told it did, to now were everyone knows type 1 is genetic, where insulin is made in a lab, where syringes, and even pumps come on free prescription, where diabetics regularly wow people with their abilities (think Sir Steve Redgrave), and where the medical engineering has taken us to the point where we can be as normal as the next person (if you can define normal!). Even if there isn’t a cure in my lifetime, the chances are pumps will one day have full feedback loops and will be allowed full control with no human intervention. Believe me, like the backpack pump of 1982, it exists and is just around the corner.
As my Institution (of Mechanical Engineers) likes to say, “you’re never more than six feet from an Engineer”. Long may that continue. Engineers don’t just change worlds, they change lives.