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Doctors did not believe that only two-year-old Agnieszka could suffer from diabetes. They only started testing her for the disease after she fell into a coma. How were diabetics treated in the 80s, when there weren’t even blood glucose meters available yet? The methods – from today’s perspective – seem bizarre.
- Agnieszka has been treating diabetes for over 30 years. He hardly remembers the origins of the disease. She was diagnosed as a two-year-old when she fell into a four-day coma
- Agnieszka associated the 80s with stabbing with a thick, coarse needle and the nights from which she would wake up drenched in sweat. She recalls how doctors prescribed her pancreatin, her glucose level was determined on the basis of a urine test, and because of an illness in the card system, she was entitled to … triple portion of meat
- Diabetologist Dr. Jacek Walewski, MD, PhD compares treatment in the People’s Republic of Poland to the options that diabetics can use today. Unfortunately, reimbursement is still a limitation for people with diabetes
- More information can be found on the Onet homepage.
Mom recognized the disease faster than the doctors
Agnieszka Linke has been struggling with type 1 diabetes for as long as she can remember. She was diagnosed with the disease back in the 80s, when she was a little girl. «I am 36 years old and now 38. I do not know any other life. I do know convulsions, sugar at the level of 500, hand tremors, hypoglycaemia »- writes in a letter to the editorial office of MedTvoiLokony.
– Back then, there weren’t many people like me diagnosed. I remember my mums waiting in line to see the doctor. Anxiety, fear, shaking hands.
In Agnieszka’s case, a chronic disease is a memento of rubella. Diabetes was detected in our reader earlier than the doctors in our reader, my mother, who liked to read medical publications, was knowledgeable about diabetes, and when she noticed her daughter’s first symptoms, she immediately put the facts together. However, when she mentioned her suspicions to the specialist called for a home visit, he was indignant: “What are you making up?” The sugar test was carried out two days later – out of necessity. Mum took Agnieszka to the hospital when she – as a two-year-old girl – fell off her chair. She got a diabetic coma that lasted for four days.
– Nobody expected that a small child like me could have diabetes – says Agnieszka.
The disease influenced her entire childhood. From an early age, she was told to stick to strict restrictions. At first she did not understand why her friends could eat sweets and she could not. She rebelled, wanted to do in spite of it.
– Once I got a lot of low sugar during the night. There was already something like glucagon, but the baby won’t wake up that easily. My mom already had experience, so she knew that when I started to sweat, it meant that the sugar was flying. When I woke up in the morning, I looked at my mother and saw that she was totally exhausted, as if she had run a marathon at night. And I was all sticky. These are my childhood memories: everything stuck, everything stabbed – says Agnieszka.
What was known about diabetes in the People’s Republic of Poland?
In contemporary Poland, knowledge about the diagnosis and treatment of diabetes was still in its infancy, and access to doctors – especially in smaller towns – was very limited.
“Maybe someday, when I finally get together, I will write my story, how in the 80s people tried to treat us with a triple dose of meat, how they tried to help pancreatin with a diabetic pancreas, how blood sugar was tested on the basis of sugar in the urine” – we read in Agnieszka’s letter to our editorial office.
– I still “caught up” with the cards. The amount of meat per person was calculated. Diabetes were given a larger number because meat was treated as a replacement for carbohydrates. Glucometers were not widely available, so doctors did not have the basic tools. They rented single copies for the entire voivodeship center. I had insulin given in syringes, with thick needles, which I still keep somewhere at home. Today I cannot imagine stabbing a two-year-old child with something like that. The first pens appeared only in the 90s – our reader recalls.
We asked a specialist about the management of diabetic patients in the People’s Republic of Poland. The diabetologist confirmed that at that time the methods that hardly anyone remembers were used then.
At that time, there were no blood glucose meters and the only parameter was urine sugar. Blood glucose? But who will go to the clinic every day and draw blood several times a day? On the basis of glucosuria and its amount, a decision was made on insulin doses. In the 80s, animal insulin was available: pork and beef, administered in ampoules with thick, reusable needles. First of all, we did not fully know when its onset of action is, when it is peaked, and when such insulin stops working. It was individually variable. Due to the fact that it had a different composition (because it was not human), such insulin caused various immune reactions, and above all intensified subcutaneous adhesions at the injection sites.
As for the diet at the time, diabetics ate what was on the market, and there was little … So doctors did often propose more card meat, which was the lesser evil. A high-meat diet is not a good solution because it burdens the kidneys and contains a large amount of animal fats. As for pancreatin, as far as I know, this was not a typical supplementation in patients with type 1 diabetes.
New methods of treating diabetes, new problems of patients
Currently, not only glucometers are available, but also other minimally invasive systems measuring blood glucose levels.
– Some have alarms when glucose goes below (or above) a certain level. Such systems are also associated with modern insulin pumps, which, for example, catch a drop in sugar, raise an alarm and stop a constant insulin infusion – emphasizes Dr. Walewski.
Insulin analogues, i.e. preparations that are modified in such a way that they closely resemble one’s own insulin, also function in common use. You can now use personal insulin pumps that are self-programmed by the patient and provide a constant infusion of insulin. In addition, there are postprandial insulin boluses. In the treatment of diabetes, something is changing all the time, new solutions are constantly being introduced.
– Insulin pumps have already appeared on the American market, which adjust the dose of basal insulin based on self-measurement of glucose – a pump is currently being developed that will also be able to administer bolus doses on its own. So there would be a closed system, without significant patient interference – explains the diabetologist.
This does not mean, however, that diabetes in Poland can fully benefit from the most modern methods. The barrier is the reimbursement.
– What hurts me the most is that as an adult I am not entitled to a refund CGM injections, i.e. a system of continuous blood glucose monitoring in real time. I should have it at least three times a month, which would cost almost PLN 500, but I can’t afford it – admits Agnieszka.
– Treatment with personal insulin pumps is largely reimbursed, including systems for continuous glycemic control. Unfortunately, not every person qualifies for this treatment, but Patients up to 18 years of age have a discount to the cheaper continuous glycemic control system. Also, long-acting analogues are not fully reimbursed (only at the level of 30%). Glucometers are free, and strips for patients treated with insulin have a significant level of reimbursement. Unfortunately, the complications of diabetes after many years of illness are irreversible, despite the increasing possibilities of self-control and treatment – explains Dr. Walewski.
Do you suspect you may have diabetes? Buy a diagnostic test package and check your health.
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Self-discipline, or how to make friends with diabetes
Type 1 diabetes accounts for only 10 percent. all illnesses. So far, its causes have not been fully explained. It is known, however, that genetic predisposition may be involved. The treatment of this disease is life-long, but thanks to self-control and the types of insulin available today even 80 percent of diabetics can maintain normoglycemia. So what is the recipe for not getting diabetic?
– Chronic diseases are about making friends. Either we live together or I fall because I will always be in a lost position. We have to stick to a diet, be careful about what we eat, although this diet does not keep us in control as much as people suffering from type 2 diabetes – says Agnieszka.
– In diabetics the days are very schematic and perhaps the most difficult is to adapt to this schedule. It was easier for me because I was a very disciplined person since I was a child. When I approach a task, it is always with a plan. This is how I was brought up, this is my character, it was always easier for me this way. I was and am so lucky and healthy that I did not give up and I am counting on the progress of medicine all the time. Every day I listen to the news, hoping that I will disconnect my insulin today and stop counting what I eat.
Despite her illness, Agnieszka gave birth to two completely healthy children.
We encourage you to listen to the latest episode of the RESET podcast. This time we devote it to emotions. Often times, a particular sight, sound or smell brings to mind a similar situation that we have already experienced. What opportunities does this give us? How does our body react to such an emotion? You will hear about this and many other aspects related to emotions below.
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