Insulin - A Life Saver  & Those Hypos

Insulin was extracted from a calf pancreas, a by-product of the meat industry, in a laboratory loaned by J J R Macleod in Toronto, Canada by Frederick Banting in 1921. Charles Best assisted in analysing blood glucose using chemical tests. The insulin extract was refined by James (Bert) Collip. The first insulin injection given to a human on 11 January 1922, was a 14-year-old boy called Leonard Thompson.

As mentioned, in previous pages insulin was available in different concentrations denoted by the U numbers, U20, U40 & U80. Each one being twice the concentration of the lower value insulin.

On my diagnosis in 1954 insulin was derived from animals it was either beef or pork. I only ever used the beef variety.

As well as the different concentrations, insulin came in various types. The first insulin that I remember was a once-a-day injection of Lente (Insulin Zinc Suspension). I'm not sure when this was & I have no idea of the dose that I had at the time. It's been a while now!

My consultant Dr Bolton set the type of insulin. the dose & carbs required 'Woe betide you' if you tried or even thought to change this.

These 'longer acting' insulins could last up to 36 hours. The problem was that you had to eat your meals at set times during the day. You were always feeding your insulin, meaning that you couldn't miss a meal because of their long action. So, a mid-morning & mid-afternoon snack was required, as was one at bedtime. All this to avoid the dreaded hypo.

Eventually I went onto two injections a day, where I had a quick acting Soluble or Neutral insulin the & an intermediate action insulin such as Isophane (NPH) as the background insulin. Some diabetics were prescribed a quick acting insulin mixed with a longer acting insulin to provide a quick & long action. But I was never prescribed this.

I found when using Isophane it didn't last as it should, causing my blood sugars to rise mid-afternoon. With my consultant's permission I had to divide the dose in half injecting it in the morning & the evening. Although it was 'off licence' that worked much better for me.

In 1982, Eli Lily first produced a U100 synthetic 'human' insulin & in 1996, the first synthetic 'analogue' insulin was produced it more accurately copied how natural insulin works in a non-diabetic person.

U100 Insulin syringes were manufactured so that 1 unit of insulin became 1 mark on the syringe much safer to use. The old animal derived U20, U40 & U80 insulins began to be slowly phased out.

I am presently using an analogue insulin the 'Ultra-Rapid' Fiasp. Which was approved for use in pumps & is faster than my previous insulin NovoRapid.

Insulin is a life saver to all of us Type 1s, for which there is no cure. We just cannot live without it.

I will be forever grateful, to Banting, Best, Macleod & Collip, as if not for their work on insulin I certainly would not be here today. 

They sold the patent for $1 each to the University of Toronto, so it could be "accessible for all".  50% of people around the world who are in need of insulin cannot reliably access it because it is unavailable, unaffordable, or both.  People are dying daily because of this. 

  A campaign by the charity T1 International is trying to get #insulin4all.  Please press link below.

Those Hypos

I've mentioned hypos a few times, well hypos (hypoglycaemia) are the scourge of diabetics.  My current go-to for hypos are jelly babies. Each one is worth 5g Cho.

When I was a child. I remember waking up in the morning, my face & pillow sticky with sugar because Mum had been spoon feeding me sugar in water during the night because I'd had a hypo. I had woken the house up screaming & shouting but, in the morning had no memories of the event.

Another memory early in the morning around 3am, is becoming aware of sitting on the worktop in the kitchen surrounded by empty chocolate wrappers & my wife asking if I was okay. Greta had been woken up by banging kitchen cupboard doors! Chocolate was my go-to for hypos back then but nowadays not recommended as the fat content can slow absorption down. 

Now I am normally aware of any coming hypos during the day by alarms going off on my phone & at night I use a wonderful device on by nightstand called a M5 Stack monitor it is a DIY programmable device which I have by my beside. This works with my current DIY setup, getting it readings via wifi from Nightscout.  

My M5 Stack showing my blood glucose readings updated 3 minutes ago.