Living with type 1 diabetes is not always easy, but things have certainly changed dramatically since the middle of the last century. That might seem like a long time ago, until you realize that people born in the 1950s are only in their 40s and 50s today.
Type 1 diabetes was not as well understood fifty years ago and its management and treatment was certainly very different to that which we see today. Indeed, if you ever find yourself getting frustrated with living with diabetes, it’s worth taking a moment or two to compare your situation today to that of people born in the middle of the last century.
People born in the 1950s and diagnosed with type 1 diabetes were looking at a death rate of about 20% within 20 years of diagnosis, rising to a staggering 30% just 25 years after diagnosis. For people born in the late 1970s, and who are now in their late 20s, these figures have dropped dramatically to just 3.5% and 7% respectively.
Type 1 diabetics born in the 1950s also faced a 25% chance of developing kidney failure, which in those days could not be detected in its early stages and, once detected, it was virtually impossible to control the progress of the disease. Today, fewer than 10% of diabetics develop kidney disease and modern drugs such as ACE inhibitors and ARBs can slow the progression of the disease and, in some cases, prevent it from developing into kidney failure.
For 90% of people with diabetes, diabetic retinopathy would rear its ugly head within 25 years of their diagnosis and this accounted for 20% of all cases of blindness in people between the ages of 45 and 75. Nowadays, laser eye surgery and closely monitored follow up treatment can reduce the risk of diabetic retinopathy by as much as 90%.
Diabetic mothers faced a risk in those days of seeing major birth defects in their babies at about 3 times the rate seen in the general population. Today, close monitoring and control of blood glucose levels throughout a pregnancy have reduced the risk to just about the same as that seen in the population at large.
In the 1950s diabetics monitored their blood glucose levels by testing their urine and this meant that their tests were always looking at their past levels, rather than their current levels. The urine test also detected only high levels of blood glucose and did not pick up often dangerously low levels.
Finally, patients had to rely on injections of animal derived insulin to treat their condition and such things as today’s variety of insulin formulations, together with pumps and insulin inhalers were still in the future.
Today the risks from type 1 diabetes are much lower than they have ever been and the management of the condition makes living with diabetes far easier. But, much more exciting is the future for those with type 1 diabetes.
Research over recent years means that we now understand far more about the condition and, in particular, know far more about the underlying biology of diabetes. Current clinical trials and further research will undoubtedly mean that we will continue to see advances in the management of the disease and, hopefully, see a solution to the problem of reversing the autoimmune destruction of insulin producing cells before too long.
