World Diabetes Day - Honey, I lost the Insulin! - by Leona Curtis-Oliver

This year marks 100 years since the invention of insulin. This foul smelling, bitter tasting liquid is the sole reason our daughter Sisi has survived the last eleven years and counting and our family is together for which we are all immensely grateful.

One Christmas, we lost all the insulin in the back of a taxi in Washington DC and our lovely hotel concierge waved his magic wand and a Doctor’s prescription appeared almost instantly. My husband nearly had a heart attack when he saw the pharmacy bill! Once on a plane to London we lost the entire bag and the following 24 hours were spent locating a private GP near Heathrow at great expense. I can safely say we have lost and had to find insulin virtually all over the world! I can tell you that in Italy you can buy it without a prescription over the counter and so on. Oh yes, we’ve paid heavily the cost of losing all the insulin! You’d think we’d be more careful.

Of course, the type of insulin used these days looks very different from 100 years ago when Dr Frederick Banting worked out how to remove insulin from a Dogs pancreas and then kept another Dog suffering from severe Diabetes alive for a further 70 days, in fact the Dog only died once they’d run out of the insulin. In 1923, Banting and his assistant received the Nobel prize for Medicine. Eventually, insulin became mass produced from pigs and cattle.

In 1978, the first human synthetic insulin was genetically engineered using e coli bacteria. Today, most children are on a version of synthetic insulin which comes in two forms. The first is a short acting insulin which takes about an hour to kick in and lasts for only 4 hours. The second type is a long acting insulin which is taken every night before bed takes 4 hours to take effect and lasts approximately 24 hours. These insulins come in pre packed pens for convenience and you attach a needle, squirt a few drops into the air to remove bubbles and you’re good to go.

The management of Diabetes has come a long way even in the last 11 years. Our daughter Sisi, wears a continuous glucose monitoring device which measures her blood sugar via her interstitial fluid, giving us a blood sugar reading which is around 5 minutes old and indicates with an arrow if she’s crashing or stable.

Before she eats anything, we measure the carbs, check her blood sugar reading, do some fiddly maths including her insulin ratio and correction dose and then she can eat and we pray we got it right. Everyday, is a science experiment because there are other factors to consider which we cannot always predict. Intense sporting activities can depress sugar levels for up to 8 hours. Exam stress can increase sugar levels. Illness can increase sugar levels and cause the body to produce ketones.

This past week she’s been fighting off a virus and as a result she ended up in the hospital, on a drip (thank you Mediclinic Parkview for your exemplary care) due to the presence of these pesky ketones. In a type 1 Diabetic, these can quickly become catastrophic. Ketones are a sign that the blood has become too acidic and the body is on a fast track motorway to DKA or Diabetic Keto Acidosis, organ failure and death. A few years ago, she spent over a week in the excellent ICU at Parkview where the Doctors saved her life.

In addition to monitoring her blood sugar, we also keep an eye on her blood ketones with separate ketone test strips which expire every 3 months. There are specific symptoms we look out for when ketones appear including fruity breath, black under eye circles, weakness, nausea and vomiting and stomach pain