A Blast From The Past: Diabetes in 1999


This morning I was feeling inspired by the interview I did with JDRF’s Aaron Kowalski about the Artificial Pancreas Project,  so I did a little google searching about artificial pancreases.  I was looking for recent news, but instead I came across this article from the New York Times, published on December 7, 1999 — just over 10 years ago. In 1999 I didn’t even have diabetes — I was a college junior, happily eating carbohydrates without fear. But people with Type 1 diabetes might have read this article and gotten a little excited. Check out its lede:

One day soon, perhaps as soon as a few years, many diabetics may forever throw away the lancets they use to prick their fingers for blood sugar tests and the needles they use to inject themselves with insulin.

Instead, they may be wearing bracelets or even earrings smart enough to sense and report glucose levels continuously to an artificial pancreas: a surgically embedded pump that dispenses just the right amount of insulin into their bloodstreams.

Whoof, that’s funny, isn’t it? I think living with diabetes requires a certain level of gallows humor to begin with, but there’s something especially cruel about how every couple years (or, hell, months) a news report comes along promising that “within a few years,” the hassles and burden of living with diabetes is going to be removed. (And with cute earrings, to boot.)  The problem is that “within a few years” is the equivalent of “tomorrow” — forever pushed into the future. Also depressing: as recently as 1999, there were only an estimated one million people in the United States with Type 1 diabetes. Today, there are closer to three million.

But part of the article is actually very inspiring —  because while we might not be wearing glucose-sensing jewelry yet, some of the hypothetical technologies it describes actually have come to exist. Take, for example, the end of this paragraph (it starts with the mandatory explanation of what can happen if things go wrong):

Diabetics who can maintain normal or close-to-normal levels of blood sugar, or glucose, reduce the risk of grave complications like amputation, blindness, nerve damage, heart disease and kidney failure. A continuous glucose sensor, even one that is not yet connected to an automatic insulin dispenser, might help to reduce these risks. It might also be a valuable alarm clock when blood sugar drops. When that happens, people sometimes lose consciousness.

And guess what? It’s 2010 and, while still not widely in use, we have continuous glucometers — three different kinds to choose from. Hell, mine woke me up just last night to warn me of an impending low. That’s pretty amazing. And then check out this:

Dr. Siegel pointed out that the technology [i.e. getting a fully closed loop artificial pancreas] still had many challenges to overcome. ”We have one arm of it, the insulin pump,” he said. ”When a reliable, miniaturized sensor is in place to monitor glucose constantly, the artificial pancreas will be far closer to reality.”

That was the point that Aaron Kowalski made to me about last week’s announcement to create the first commercial partially closed loop system: today, unlike in 1999, all the components are actually on the table. Like all good diabetics, Kowalski — who’s  had type 1 for some 25 years — knows better than to put a hard timeline on things. But he’s still optimistic — and as a consequence, so am I. The artificial pancreas is going to happen. And I hope that if I write this same blog post in 2020, what seems hypothetical today will have become reality.

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Robert Scheinman
13 years ago

Science does move slowly. However we must do it that way. The other alternative is to try anything on a willing human. This degrades the sacredness of humanity and approaches the horrors of a world where people are objects. That being said we could always try to move faster while keeping people people. There will be deaths – like the early release of the first glitizone (I forget the name) that caused liver damage and killed some people. If society is willing to take the risk, clincians are eager to try new things.

Doran Barton
Doran Barton
13 years ago

There are actually over 300 million people in the U.S. :)

You probably meant to say “people with Type-1 Diabetes.”
Good comments, nonetheless. I was also not afflicted in 1999. I was diagnosed in late 2000. I’m still doing the old-fashioned fingerpricks and insulin pens because my diabetes isn’t very brittle, but I understand it could become more so at any time, so I keep my eye on CGM and pump options.

The poor diabetic
The poor diabetic
13 years ago

All you can do is hope, medical breakthroughs happen all the time, problem always comes down to funding and continued funding. If it happens now or in another 10 years, Great so long as it does happen.
So fingers crossed. Until then use effective diabetes management principles to keep hope alive.

Jeff Nobles
Jeff N.
13 years ago

At my diagnosis in 1973, a family friend told me he’d heard there’d be a cure in five years. Eventually I realized a cure is always five years away, if only funding becomes available.
That said, what I’ve been reading here and elsewhere about the closed-loop system is pretty exciting.

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