Truth is stranger than fiction.
Every now and then, I peruse some old textbooks about diabetes. Here are some nuggets of ancient wisdom for the reader to mull over.
"One unfortunate feature of insulin administration is the complexity created for the patient by the variety of insulins on the market and their appearance in various concentrations. The patient should know that there are available "regular" insulin, protamine zinc insulin, zinc insulin crystals, and globin insulin... Add to this the fact that insulin can be obtained in 5 cc and 10 cc vials, and in concentrations of U-10, U-20, U-40 and U-80 and it may be readily understood how the uninitiated and uninformed patient becomes easily confused.
"An additional important source of confusion lies in the types of syringes which the patient can purchase in the open market... Too often have we discovered the patient who takes U-40 or U-80 insulin and reads the dose on the U-20 scale of a 20-40 syringe. We have also frequently discovered the new patient who had been taking his insulin with a 2 cc hypodermic syringe graduated in cc and minims and reading the dose on the minim scale thinking it was units! Thus it is obvious that a patient who states that he is taking 15 units of U-40 insulin ... is actually receiving 40 units of insulin."
From The Modern Treatment of Diabetes Mellitus Including Practical Procedures and Precautionary Measures
WS Collens and LC Boas
1946
"Testing the Urine
"The more important a patient conceives himself to be, the more frequently he will examine or have his urine examined for the presence of sugar.... The simple testing 4 times daily discloses at which period in the 24 hours the diabetes is least controlled, and hen one can recitify it by the use of diet, insulin, and exercise...
"Frequent testing one or more times daily for life is encouraged. Particularly should the patient be told not to confine his testing to the specimen voided on rising fand for two reasons; (1) that it may contain sugar collected with the urine and in the bladder many hours before, whereas a freshly secreted and voided secimen half an hour later would be sugar free... (2) the rising specimen may be sugar free, due to the going without food all night, but after a meal a specimen of urine would show the presence of sugar."
From Treatment of Diabetes Mellitus
EP Joslin, HF Root, P White, A Marble
1952
"The Advantages of Diabetes Over Other Chronic Diseases
"It is perfectly true that diabetes is a chronic disease, but, unlike rheumatism and cancer, it is painless; unlike tuberculosis, it is clean and not contagious, and in contrast to many diseases of the skin, it is not unsightly. Moreover, it is susceptible to treatment, and the downward course of a patient can be promptly checked. Treatment, however, rests in the hands of the patient. It is by diet and exercise as well as by insulin, and the patients with the will to win and those who know the most, conditions being equal, can live the longest... Brains count. But knowledge alone will not save the diabetic. This is a disease which test the character of the patient, and for success in withstanding it, in additon to wisdom, he must possess common sense, honesty, self-control and courage."
From Diabetic Manual for the Doctor and Patient
EP Joslin
1953
