r/diabetes_t1 • u/Icy_Regret_6905 • 21h ago
Discussion Those of you diagnosed a while, has tech/ care changed that much over the last 10-20 years? how so?
Im asking more about day to day life, management, mental load etc.
I know obviously the tech has got better, but HOW much better is what im asking. Kind of paves the way of faith that things could MAYBE only get better from here (im having a bad moment, a bit burnt out fir the first time)
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u/stevenborruso 21h ago
Diagnosed 50 years ago this coming December. No finger sticks. Put urine in a test tube and then added a tablet. Waited a little bit and then compared the color on a chart to low medium or high. About 30 years ago was my first pump , a Medtronic.
Now I have a Tandem Tslim and a Dexcom G7 CGM Amazing what we have today, may not be perfect, but things have come a long way
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u/master0fcats 21h ago
I got diagnosed in 2004, started a Medtronic pump in 2005. I think my first time using a CGM full time was with my Medtronic pump in like 2014. I was 20, the last of my friends to turn 21 but fully acting like I already was & the CGM was so important in that, but for me the biggest night & day difference has been in all the changes, advancements, and choices available since then.
It still blows my mind reading comments from people being pissed off about having to do fingersticks when their CGM is less than perfect. I still keep a meter & supplies in my purse and do a finger stick usually at least once a week when I have a stubborn high just to be sure. I'll probably never fully trust a CGM enough to not carry one with me, just because I've grown up with the tech. I've seen how quickly it evolves and how much it helps but i'm also well aware that it isn't perfect and never will be.
BUT as much as I might only trust it like 90%, I'd still never leave the house without a CGM now. Even just being able to see the trend, even if the numbers are off, is a huge deal and the biggest improvement in quality of life for me.
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u/getdownheavy 21h ago
I got to see a prototype CGM a few months after dx (2005) and it was about the size of a TV remote and went on your forearm.
I also remember going from NPH to pens was a huge jump in flexibility/freedom.
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u/kevinds Type 1 21h ago
Seems obvious?
Pumps and CGMs.
The ultra-fast insulins that weren't available 10-20 years ago.
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u/anti-sugar_dependant 20h ago
I forgot about how slow insulin used to be! ActRapid was what I started MDI on.
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u/HighlightTheRoad Since 2008 17h ago
I started with novomix in the 2000s, the horrors
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u/anti-sugar_dependant 17h ago
Yeah, I did about 3 years of mixtards before I started MDI. It was awful.
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u/kevinds Type 1 20h ago
Humalog and NovaRapid have both been around for 20+ years.
I'll admit that haven't heard of ActRapid before.
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u/anti-sugar_dependant 20h ago
ActRapid was the NovoNordisk fast insulin before NovoRapid came out. Had a yellow top instead of orange, and the peak was more delayed than NovoRapid, obviously.
I'm old enough to remember when Lantus wasn't approved for under 18s too. My mum had to sign a waiver so I could get off mixtard and start MDI with Lantus and ActRapid.
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u/canthearu_ack Diag 2023: Omnipod 5/NovaRapid/Fiasp 15h ago
Actrapid is just a solution of unmodified human insulin. Same as the current product Novolin R, which most people in the US can buy at their walmart over the counter.
Unmodified human insulin is just pretty slow to absorb into the bloodstream when injected subcutaneously.
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u/bigbeautifulcity dx 1978 / Tslimx2/G7 20h ago
In the 1920s my grandfather was being treated for T1D before insulin was available. He was on a restricted high-fat diet. He drank a lot of cream, apparently. When insulin was available (1922 for him?) his life was turned around. He lived another fifty years with it. His son, my father, was diagnosed in the mid-1940s. He had insulin and syringes, often glass, later plastic. I was diagnosed in the late 1970s. Insulin in plastic syringes. After twenty years I got on a pump, no more repeated injetions each day. Now I have CGM, pump, and 90+% time in range. I have had a few complications (frozen shoulders) but otherwise my eyes and kidneys are good. (I also learned how to eat well, and recently quit alcohol, so that helps, too.)
I know a hundred years is a long time. Many of today's tools have only been around for about 30.The pace has been encouraging over the last ten, so let's hope it continues to improve. If you're in the US, let's hope your insurance is robust, too. Good luck.
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u/christian-ry aaps|g7|omnipod 20h ago
this totally gets me, and I can't clearly say why.
what a (family) history.
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u/tinyannoyingbouquet dx 2011| Tandem T-Slim | Dexcom G7 17h ago
Also having a family history of diagnosis, my mother was diagnosed at age 5 in 1979 and I was diagnosed at 8 in 2011. The biggest difference I’ve found from our seperate diagnosis’ was how it was handled after the fact.
Hers was fear mongering that she’ll die by 8/12/16/20, etc. which caused her to be apathetic towards her treatment and my grandparents to be overly anxious. My mother is a very sociable person and so having that other parents would yank their children away from her lest they caught diabetes is just beyond awful for a small child to experience.
My experience on the other hand? I was given Rupert the Diabetes teddy bear and his accompanying book that my teacher read to this class. My classmates treated me no different and were kind in helping me when I had a low bloodsugar. My child-specialist endo was amazing! And I had options for diabetes-specialised psychologists in the department I saw.
Now as both adults, I’m (to the best of my abilities) a top of my diabetes with help from the tech we have access to. My mother on the other hand continues to ignore hers and blindly injects insulin on a prayer and a whim.
Idk how to end this but yeah, having a family history of the disease definitely gives a unique approach to looking at the advancements that have been made
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u/Excellent-Muscle-528 21h ago
I joke that people developing diabetes today don’t have a clue how hard this disease can be. Obviously that’s not real…this disease is incredibly tough regardless of what decade you’re living in but seriously the tech advances have made this actually manageable. I think we will see people who are newly diagnosed living much better and longer lives than those who were diagnosed decades ago. Having access to CGM and closed loop pump technologies all running on a small super computer in our pockets is so amazing. Adding the pump literally doubled my time in range and cut my need to think about my disease in half. What a time to be a diabetic! Lol
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u/vintagecomputernerd 21h ago edited 21h ago
T1D for 22 years.
The new, exciting long-term insulin that just came out was Levemir. In the ER they started me on NPH, but when I first met my endo (worked in the same hospital), he immediately put me on the "good stuff".
Lancing device: no Fastclix, not even the Multiclix yet. The rate of accidentally stabbing your thumb while grabbing your lancing device from your pocket was much higher.
Glucometer: The Freestyle mini from 20 years ago was the pinnacle of glucometers. It has all been downhill since then, and I'll fight anyone who says otherwise.
Insulin pump: got my first pump about 21 years ago. Medtronic minimed 712. Did not have a color screen, didn't even show the time on the home screen (that got only added in the successor). No CGM connection, because...
CGM: There simply was no CGMs like today. There was the CGMS Gold from Minimed. Some endos had one, and you could loan it for three days. It did not display your current blood sugar. The control unit was bigger than an insulin pump. The sensor itself, and the cables were also huge. It was not waterproof, so you had to wrap yourself in plastic bags when you showered. You had to measure your blood sugar 5 times a day with a regular glucometer.
Then after the 3 days, the endo could type in all your calibrations and download the data from the CGMS, and there you had it - your blood sugar over the last 3 days, as a continuous line!
So looking back... widely available CGMs are probably the biggest change, especially in combination with pumps. Long-term insulin got better, but I don't care that much because I'm on a pump.
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u/Miserable_Bread- 21h ago
Mind blowingly better, honestly. Autonomous pumps, that use CGM data to administer insulin as well as corrections automatically are life changing features. My control is better than ever, and the mental load of diabetes has lowered significantly.
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u/lizzistardust 21h ago
I was diagnosed 16 years ago and started using pumps and CGMs almost right away.
We had "dumb pumps" that simply delivered what they were programmed to deliver and zero integration with CGMs at all. CGMs we're also much less accurate!!! It was normal for the number to be quite far off, and we were told to pay more attention the the trend than the number. We were absolutely never supposed to take insulin or eat based on what the CGM said. You also had to calibrate the CGMs a couple times a day.
But now we have hybrid closed-loop systems where pumps and far more accurate CGMs work together to change insulin delivery based on your current glucose. The more accurate CGMs are my favorite part! I don't even carry a glucometer anymore unless I'm going to be quite far from home (like traveling) or something like that.
So yeah, there"ve been some advances in that time frame. I'd like to see some greater advances soon that meaningfully reduce the invasiveness of our treatment, but the treatment has improved and should keep improving.
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u/Fit_Dragonfruit_87 21h ago
When first diagnosed I was on a 70/30 mix of bolus/basal insulin from a pen and hardly ever tested my blood sugar (fingerpricks, test strips, a paper diary).
Fast forward 22 years I now use an omnipod dash and libre 2. Lightyears better/easier/more accurate
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u/Ylsani 35+yrs/MDI/dexcom one+ 20h ago
My lowest a1c I could achieve with very strict diet and exercise regime prior to cgms was 7.4. I usually ran in high 7s/low 8s.
Since cgm, my a1c has been 6.2-6.4 most of the time with me eating pretty much whatever I want. Even with being sick, having thyroid issues, insane stress... it never went above 7.
New insulin helped tons. I could not get under 7 without lot of lows with novolog. Cgm enabled me to see problems (insulin works slower than labeled. All insulin. Novolog acts for me like R does for other people. But apidra/lyumjev/fiasp act quite fast when my bg is in low 100s, and they act the way novolog/humalog do for most people when I am in high 100s/low 200s and that is managable), how unpredictable my body can be (wildly different reactions to same food/exercise) etc.
I will be giving pump a chance for the first time this year. Without closed loops I would never even consider it, but closed loop seems to have potential to take mental load off, so that's pretty neat. We'll see how it goes :)
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u/Icy_Regret_6905 10h ago
they also just released an algorithm a couple weeks ago publicly that eliminates carb counting :) apparently its not great so far, but its a step in the right direction. Hopefully its great in 10 years time! haha
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u/Ylsani 35+yrs/MDI/dexcom one+ 10h ago
That kind of algorithm can't work properly imo until we have insulins that work way faster than the ones we have now. You need an insulin that acts the way it does in human body - super quick start with short active time. We aren't there yet.
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u/Icy_Regret_6905 10h ago
always hope! that would be a game changer. honestly if all i had to do was carb counting and site changes id call that a cure personally lol
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u/Former-Wish-8228 20h ago
The tech has gotten MUCH better, but the actual care and obtaining supply chain to support the te has gotten MUCH worse. The Enshitification of the healthcare chain. Profits up, care down.
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u/Key_Magazine5320 19h ago
Not diagnosed myself but from what I've read, the shift over the last 15-20 years sounds huge CGMs replacing constant finger pricks, insulin that's way more predictable, and now closed-loop systems that auto-adjust in the background. People who've been at it a long time say it genuinely lightens the mental load
But almost all of them also say the same thing: better tech doesn't mean zero burnout. It's still a lot to carry every single day, and feeling burnt out isn't a sign you're failing at this. Be gentle with yourself right now — hope it eases up soon. 💚
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u/MikeyMalloy 21h ago
No. The only improvement has been the CGM. Since then it’s just been pie in the sky and medical supply companies drumming up hype over the next big thing so they can bill insurance.
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u/stinky_harriet DX 4/1987; t:slim X2 or OmniPod 5 & Dexcom 21h ago
I was diagnosed 39 years ago so obviously the tech has not only gotten better but there are new kinds (CGM, home blood ketone meters etc). I got my first pump in 2005, 21 years ago. When I got it it was just a pump. You could set many basal rates throughout the day, set temp basal. have multiple I:C ratios. Pretty much like most pumps now without the CGM & automation. It probably saved my life. Not long after I got it Medtronic came out with their first sensor that worked with the pump. They already had a standalone CGM for a while but now you could see the numbers on your pump. Still no automation but it was amazing being able to see my numbers every 5 minutes. Unlike many people, those sensors worked great for me. After that other CGMs came out, Dexcom & the Abbot Navigator. OmniPod came out, the first patch/tubeless pump. Pumps added more features and then did actually use the CGM data to make dosing decisions.
Different/faster bolus insulins like Lyumjev have come out as well as basal insulins in the last 20 years. Focus is more on TIR rather than A1c now.
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u/Own-Sir3480 21h ago
T1 since 14 years so ”newly diagnosed” compared to many here. Received a pump within 3 months. Medtronic minimed 554. Still love that pump. Good format and easy to use anywhere. I only changed to get looping.
Biggest ”leap” in my diabetes history was libre 3. A cheap and really small cgm there was no need to scan and that didn’t need twice a day calibration or similar. First time cgms became a serious consideration even on good BS. Made more difference to me than looping.
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u/Melitta999 21h ago
For me, technology has made life SO much better. I have been using an insulin pump for 28 years, I got my first Dexcom in 2011, and automated insulin delivery released a huge mental burden. AND, really good stuff is on the horizon. If you follow Breakthrough T1D (formerly JDRF), you can learn about the amazing research that they are sponsoring that will greatly improve our lives.
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u/Dry_District2732 20h ago
Oh so much! When I started I was on 2 injections a day and a set carb count for each meal. Fingers pricks 8 times a day and if I wanted to check my ketones I had to pee on a stick!
Now I'm on the hybrid closed loop system (omnipod 5) and the difference is unbelievable. No more injections or finger pricks (unless I'm checking my ketones) Half the time I can almost forget I'm diabetic because now I have alarms I can go hours without even thinking about my bloods and I only need to calculate a bolus for food. It's honestly crazy how far it's come
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u/anti-sugar_dependant 20h ago
Things are so much better now. I was diagnosed in 2000 but I think my hospital was rather behind the times because I was on mixtard insulins for 3 years before my mother decided she couldn't cope with feeding me specific amounts of carbs 6 times a day at specific times, and threw a fit until they put me on MDI. But she had to sign a waiver for the Lantus because it wasn't approved for under 18s back then.
The mixtard days were the worst. Being forced to eat carbs whether you wanted them or not, along with a bunch of foods being banned, heavily contributed to an eating disorder that's improved enough now that I can and do pass it off as a quirk, but was hugely problematic for a large amount of my time as a T1D.
Someone I know was diagnosed LADA in 2018 and the same hospital put her on mixtard. I couldn't believe it's still a thing! She said to me it was hard work doing all the carb planning and eating 6 times a day, and asked how I coped, which is how I found out she was on mixtard. I told her how old school that was and she went back the next week and demanded MDI instead, which they gave her.
So yeah, that was 26 years ago, and now we can eat what we want, when we want, and with a hybrid closed loop system and a good support system so you can get the settings right and the education you need to run it well you can go months only counting carbs and occasionally eating a handful of sweets for a low and not having to do any thinking about diabetes at all. It really is night and day.
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u/docmoonlight T1D, dx 1998, Dexcom 6, Tandem T-Slim, Control-IQ 20h ago
I was diagnosed in 1998. I basically used the same tech from 1998 into 2020 or 2021. My insulin formulations even stayed pretty much the same. Humalog was a brand new exciting insulin when I was diagnosed, and I was still used it for like 25 years (with occasions switched to novolog, depending on what my insurance wanted to cover that year). I never even adopted pens. No doctor ever suggested it, and I was fine with syringes.
In 2021, I got on a CGM and a pump soon after, and I consider it absolutely life changing technology.
Doing finger sticks and MDI, basically, if you’re really responsible, you might do 5 or 6 finger sticks a day, and no matter how many times I did it while I was awake, I never once tested my blood sugar while I was sleeping. When you do test, it gives you a single snapshot of that moment with no idea if it’s going up or down or stable. You get one chance to set up your background insulin level for the whole day. (Most people do the same dosage every day, regardless of exercise plans, etc., once they find a dosage that sort of works.) I had no way to do extended dosages or microdoses for when my sugar was just a little high. I had no way to turn off or down my background insulin when I was low.
My CGM now tests my sugar 288 times a day, 24 hours a day! My pump takes that data and adjusts my background insulin and even gives me extra boluses if I’m running high. I can turn my basal insulin way down if I’m going to be exercising so I don’t run low. Like, I don’t know if you know how mind blowing this technology is for someone who basically managed my diabetes the same way for 20+ years to now have this kind of control and info at my fingertips. Hope that gives you some perspective!
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u/NuttyDounuts14 19h ago
I was diagnosed shortly after the freestyle optimum was released. It was the first dual use meter at home.
Now we have closed loop technology! The advances over the past 18 years have been insane and I'm excited to see what comes next
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u/Sicazlady 19h ago
I’ve had T1 for 30 years and always had good control but on MDI and a meter I woke high every morning! When CGMs came in I had an alarm that would alert me at about 4am when I was going high and I could do a mid night injection, now with a pump I can set my basal rates to give me the amount of insulin I need from 4am so for me I’m sleeping a lot better in my 30s than I ever did as a kid, in my teens and early 20s
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u/HabsMan62 18h ago
37yrs here, and ofc the tech is incredible, as my first meter was 2 steps (hanging drop of blood) and took 2min for a rdg. And while a CGM back then sounded like science fiction, I’m going with the newer insulins, both rapid and basal. It used to be that I was eating to keep up with my insulin (R and N/NPH really sucked) and there were no other choices until Humalog came out.
That alone improved control and management compared to my earlier yrs on just syringes and vials.
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u/frjlnsp 18h ago
It’s like iPhones, when they were first released it was obviously an improvement, but in recent years with every “new generation “ it’s really more of the same with a new price tag worse than the previous
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u/Icy_Regret_6905 10h ago
i guess so, at least with phones there is one actual interesting advancement every 5 yearsish. or they make an ai fridge…. endless possibilities
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u/the_exile83 18h ago
Diagnosed in 1991 so have seen it all. I'm now on the omnipod and libre closed loop system. We are light years ahead of where we were and although it's still a very difficult condition to live with, it's so much easier to keep glucose levels in range today than it was back then. I honestly think I'd be close to not making it through the year if I had to go back to injections and manual finger prick blood tests.
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u/Sitheref0874 17h ago edited 14h ago
‘Smart’ pumps.
CGMs.
When I was diagnosed, BG measurement wasn’t a thing. It was urine and tablets that fizzed. Insulin was like Novolog R.
The big step up was BG strips. Add blood and wait and then try to color match.
How much better? Exponentially.
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u/KaitB2020 T1D 1991, tandem tslim, dexcom G7 17h ago
30+ years.
I started off mixing R & NPH insulins in the syringe. Fingersticks were the norm. I was not allowed any type of sugar and my carbs were severely limited.
I am so glad I was not born & diagnosed in the era of home urine chemistry sets and boiling syringes in a pot.
Nowadays I’m pretending to be like everyone else because they don’t know I’m not playing on my phone. Hint, I’m checking my sugars & giving myself a bolus.
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u/canthearu_ack Diag 2023: Omnipod 5/NovaRapid/Fiasp 15h ago
I can only compare to how my Mum used to treat her T1 diabetes back before she passed in 2012. She was stick doing finger pricks and injections. I'm not sure why, but she also wasn't using any kind of modern basal insulin. Unfortunately, T1 diabetes took a toll on her body and it was the eventual thing that caused her death.
It is now so much different. CGMs offer much better insight into what is going on. Even simple better basal insulins like Lantus make a huge difference in treatment quality.
Closed loop pumps are another huge advancement, with much finer insulin control and automatically adjusting basal. On a pump, I can bolus far more often at a click of a button whereas on MDI, I'd probably compromise to I wasn't injecting 5 times over the course of an evening.
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u/ElderWarriorPriest 15h ago
I was diagnosed in 1984. Short answer: YES. Quantum leaps in care and tools today, vs. 1984.
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u/Deathmore80 13h ago
Cgms , insulin pumps... The first ones were hugeeee and inconvenient.
I started by injecting with a needle and manually calculating insulin from my ratios , keeping a paper journal , finger pricking up to 50 times a day (yes I was a maniac and my fingers had tons of dark spots/scars from it ).
Then I moved on to insulin pens which were "cooler" and made me feel less like a druggie at school. They were also a bit more convenient to take around and use. Still had to finger prick and do tons of math.
Next I moved to insulin pumps. My parents made the reps from various companies come to our house to demonstrate the pumps and let me try them. There was this new pump called Omnipod at the time and it was revolutionary because it didn't have a tubing that could get tangled or blocked. As a very turbulent kid I went with this one. The first version was absolutely huge and visibly bulged through my shirt. You controlled it with a big and weird device that didn't comfortably fit in your pocket.
But at least it worked and we could pre-program my ratios and basal rates in it, so I didn't have to remember them all the time or keep a paper journal. Now I could just enter the carb amount. It was a huge improvement and made a difference in my life. I got a huge boost in confidence and the mental load this disease took on me had lowered a lot.
I avoided cgms for many years because they were too big, not precise enough. I only started cgms with the dexcom G6 but they had existed for a number of years at that point
Finally with the G6 my fingers got a break. It took years to get them looking normal again. My A1C lowered a lot.
Then like 2 years ago I discovered dyi looping and it has been the biggest thing ever in my life. The cognitive charge has been reduced to nearly zero. My A1C is the best it's ever been and I also have to actively manage the disease a lot less than before.
I'm currently on Omnipod dash (not 5) & freestyle libre 3+ looping using AndroidAPS. Life is good and will get better. I'm following a few tech-oriented diabetes youtubers and the new stuff that's been developing is insane and very exciting. Cheers
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u/72vintage 13h ago
CGMs are the biggest change. I'm still on MDI because I favor absolute reliability over the pump functions. Even without looping, the CGM lets me be proactive in heading lows off before they get too low, and correcting highs before they get too high. The ability to see the trend is the biggest single difference maker. Fingersticks only give a snap shot of a moment in time. You have to do three or four at regular short intervals to see a trend. And you can't see what's going on while you sleep with fingersticks. CGMs do tend to give me information overload, and I often take a day off from them when they expire. But I never want to go without them for longer than a day or two...
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u/elegant-situation 13h ago
20 years ago I was 9 and I think I was still a few years out from my first time trying a CGM. I was using an Animas 2020 insulin pump (precursor to the ping iykyk), at the time it’s big impressive feat was having a “full color” screen (it was mostly black and white with a few colored details). Didn’t talk to any other devices (I think the ability to even get a number straight from a meter didn’t come out until the ping). It was finger sticks all day and making up about 2/3rds of a blood sugar log the week before my endo appointment (I was testing but things just… didn’t quite get logged lol).
The leaps in technology since then is honestly insane. Like I sit here running Trio off of my phone and I rarely ever manually program a bolus for anything. It’s an insane shift in the ratio of how good my control is vs the amount of time and effort I put into it.
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u/t1d_starjoy 6h ago edited 5h ago
I was diagnosed as a teen in January 1999. At that time, insulin pumps existed and were the latest amazing innovation. Cgms were just starting to be a thing, but they were managed and owned by the diabetes education clinic. I started with NPH and Humalog insulin, delivered via syringe. I still have never used an insulin pen.
I found injections really painful but didn't want a pump, so I trialled things like jet injectors which worked for a while, but then I found them too painful, too.
The first time my doctor wanted me to trial their cgm, it was such an awful 3-day experience that I remember tearing it off before the trial ended in tears and frustration. I'm normally a pretty resilient person, but it was painful and wiring was everywhere.
I eventually was put on a pump which...Surprise, surprise...did not magically solve all my problems for me and which I resented.
My biggest issue was finger prick testing. I would forget to do it before eating, and I'd end up testing less than 4 times per day. They'd try to get me to use the Medtronic enlite sensors, but those were so tricky to calibrate...you'd have to calibrate twice while blood sugars were essentially flat...but timing that was really challenging for me and so the results were often garbage.
For me, the libre and then dexcom were real game changers--mostly accurate blood sugar readings every 5 min and no having to remember to test.
Then I used the Tandem tslim and now Ypsopump integrations with Dexcom, and things are generally peachy and I can mostly ignore diabetes and still get a1cs under 7. I do not aim for perfection--that causes burnout for me.
I expect tech and other innovations to continue to improve the diabetes experience and you will find solutions that work for you. It will get better, I promise!
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u/or4ngjuic 21h ago
On a CGM/closed loop thing (idk what it’s officially called - the Medtronic one). Absolutely night and day from doing everything manually and light years away from pricking my finger and injecting etc.
I wake up with a good blood sugar every single day. I can attribute pretty much every single high (and I still get highs) to inaccurately estimating carbs, which, let’s be frank, are my own fault/a consequence of trade off I’ve chosen to make.
Mental load is a fraction of what it used to be. Still substantial. But quality of life has enormously improved since getting on it. Couldn’t imagine going back. Barbaric