We are conscious that yesterday and today of diabetes are not the same. The development of the control and treatment criteria have been very relevant for the management of this disease.
With this new section we are going to travel across the time, sharing with you the diabetes’ evolution during all these years. Week after week, we will add new content with your help. Yes, that is! We want you to help us to fill out this section with before and after photos of diabetes control.
Thus, if you still have some material don’t hesitate to share some of them with us via mail to firstname.lastname@example.org
1923-2018 Evolution of the insulin syringe. Model “Lilly`s iletin syringe” VS Tresiba
One of the first syringe to be used was the Lilly`s iletin syringe which was used with the first insulin in the market used in humans, in 1923 (The clinical trials were carried out in 1922 and, the following year Eli Lilly launched into the market the first commercial insulin with the name “Iletin”.)
It is known that the world is in constant evolution so that the needs of people with diabetes also change. The latest in technology is the pre-filled insulin pen FlexTouch from Novo Nordisk. Its system without extension button for injection ease insulin administration independently to dose. It is the favorite for patients and healthcare professionals.
1956-2018 Evolution of the urine test strips and capillary blood glucose “Dextrostix”
Formerly, confirmation of the diagnosis of diabetes mellitus was carried out by testing the patient’s urine. At such times, it is discovered its sweet taste, it was its yellowish color very similar to the dissolution of honey in water, which gave rise to the name mellitus “honey”. Bearing in mind that the Greek translation of diabetes “siphon” mellitus “honey” would be something like “siphon sweetened in honey”. The term “siphon” has its logic considering that it refers to the large amount of urine that diabetics eliminate.
In 1956, the American scientist, Helen M., launched the first colorimetric test strips for urine glucose analysis under the name of Clinistix. Later it would appear another type of strips like Ketostix to detect the acetone in the urine or Albustix to detect the Albumin.
In 1965, the company Ames, currently known as Bayer, develops and introduce into the market the first capillary blood glucose strips Dextrostix. The reactive strips were of paper. It was enough to apply the blood in the strip and wait for 1 minute to read the result. Value interpretation had a high error rate, since depending on light intensity, the color could vary.
Nowadays, measuring has improved notably, with a large variety of strips in the market. Blood glucose level measurement is easy, comfortable, cheap and faster to carry out. Real-time measurement in the analysis of both blood and blood ketone bodies.
Thank goodness! Can you imagine a doctor testing urine to know if a patient has diabetes currently?
1960-2018 Evolution of the insulin pump. Model “Autosyringe” or “Big Blue Brick”, the first commercial insulin pump
1960-2018 Autosyringe vs Accu-Chek® Insight. It was in California, in the early 60’s, when Arnold Cádiz invented the first insulin pump.
It was a large artifact, placed on the back. In was only in the early 80’s when the CSII, or continuous subcutaneous insulin infusion, was considered as a possible option for administering insulin to patients with type 1 diabetes.
At the end of 1980, this solution was used only by the minority of patients, those with diabetes cases more complicated, with unsatisfactory results.
The first model of insulin pump to be commercialized was the “Autosyringe”, nicknamed “Big Blue Brick”. Despite the newness, these medical devices did not administered insulin safely, neither were easy to use (some of them needed screwdriver to be used) and they were uncomfortable to be transported due to their big size and weight.
In the 90’s, great improvements were produced on insulin pump. The size was reduced and there were improvements on memory programming and on safety.
Our time. The treatment with insulin pump has become very popular due to it enables to have a more flexible lifestyle, by replacing the need of injecting several times through the continued administration of precise doses of fast-acting insulin on a twenty-four hour basis.
It decreases the severity and frequency of hypoglycemia episodes. Furthermore, basal rate can be set for different speeds, as well as increase or decrease the dose temporally. As disadvantages, note that, in case of suspension the insulin supplies, the glycemia can increase very fast and there is a greater risk of suffering a ketoacidosis.
According to an article run by Redacción Médica, ‘according to Fenin Diabetes Technology Group’s last data, our country (Spain) is placed in the penultimate position with only a 4 per cent of users of insulin pump, what is well below the European average, that is 15%’.
The new insulin pump model to which the image refers is Accu-Chek® Insight. It is an easy to use insulin pump with prefilled insulin cartridges. The advantages of the product include the fact that it is able to connect via Bluetooth and also includes an external meter connected also by Bluetooth and incorporates a clinically validated bolus calculator, which enables to calculate the bolus safety an easily , in addition to a remote control for a discreet use.
1970-2018 The first glucose meter A.M.R Ames Reflectance Meter vs Dexcom G5® Mobile
The first glucose meter was developed by Anton H. in 1970, which was named A.M.R Ames Reflectance Meter. It enabled patients with diabetes to monitor their blood glucose levels by themselves. It had several inconveniences like its weight or its high price, and also its rechargeable batteries used lead acids, which were very dangerous because of its ease spill.
Luckily for us, currently, it has been developed the technological system Dexcom G5® Mobile, the first real time continuous glucose monitoring system (CGM), appropriate for use on adults and children from the age of 2. Thanks to Bluetooth technology, integrated in the transmitter, it is possible to remotely see the blood glucose levels, the trends and data on a compatible smart device. Better yet, with Dexcom G5 Mobile, finger confirmation checks are no longer necessary to take daily glucose management controls.
1981-2018 Autoclix: The first fingerstick for the extraction of capillary blood
In 1981, Boehringer developed the first injector Autoclix, a heavy and big device to get blood samples, that could be pre-configured to obtain multiple penetration functionalities according to the type of skin, because of it had not regulation of the needle like the nowadays fingerstick. There was only one way for pricking and if you wanted to change the depth of a prick it was necessary to use a different colored injector.
This process was carried out at the time of obtaining the sample and the results were obtained after 1 minute, depending on the glucometer that was used.
Nowadays, fingersticks usually contain a regulator that allows to regulate the depth of the puncture without needing to remove any piece. In addition, its size has been reduced considerably, being more practical when it comes to carry it in your pocket.
As novel product, there are painless fingersticks like Genteel, which incorporates a vacuum capsule that enables to poke anywhere on the body and extract blood samples for glycemia, without pain. Its needle penetrates in the skin at a rate of 18 millisecond, without reaching the layer where the nerve endings are located.