INSULIN AND DIABETES.

Press, Volume LIX, Issue 17936, 3 December 1923, Page 10

INSULIN AND DIABETES.

by one who has tried BOTH.

(SPECIALLY WBITTEH FOR "THE VS.SS3.")

Insulin —that preparation from a certain portion cf the pancreas of animals, that has had so radical an effect upon the treatment of diabetes—has been in use now in New Zealand for about four months, and the medical men of the chief hospitals of the Dominion, and others, have had an opportunity of collecting a certain amount of first-hand data in connexion with the use of the new specific. A fairly voluminous literature has already arisen in other countries, chiefly Canada, America, and England, which was available, but, as in other things, there is nothing like practical experience as a sure guide. No one who has suffered from diabetes "in a sever© form needs to be told that the condition is a sort of living death. The disease has one good point about it—there is no pain—but this is offset by the fact that most of the good things of life are denied one. All the pleasures of eating and drinking are banished, and that they are real pleasures one does not realise so acutely until they are forbidden. Existence becomes a weariness; rousing oneself to effort becomes almost an impossibility, mentally as well as physically, and the sufferer cannot really be blamed if he says to himself: "Is all this worth while? "Would it not be better for the end to com© quickiy ?" For over two years I struggled along under the severe handicap which the disease entails,' and in spite of a restricted diet—dieting, in other words, semi-starvation, being the only known form of treatment until the discovery of insulin —my condition became worse progressively. The final breakdown coincided with the first importation of insulin into the Dominion, and I managed to secure three bottles of English insulin, containing 100 units each, from an Auckland chemist. At this period my weight had gone down to about 10 stone from 12 stonfe 10 pounds, which had been my, average for a good many years before the onset of the disease. For about a fortnight an attempt was ma.de to' tackle my case by a rigid application of the Allen dietary treatment, but the results were not satisfactory, as I became too weak to stand the fasting necessary, so th© administration of insulin, combined, of course, with dieting, wa3 commenced.

Saved if not Cured. For about a month I received an average of 20 units of insulin a day, though now and again when it was unprocurable I had to do without, and my condition -became notably better. At the end of four weeks the improvement was very marked. No longer did I have to go upstairs one step at a- time hanging on like grim death to the banisters; I could walk up almost like an ordinary person. 1 found I could also ride a bicycle for short distances and walk about quite a lot, though still very shaky about the hocks, so to speak. It was at this stage that I was ordered into the hospital to continue the treatment. My weight on admission was 9 stone 10 pounds. While in the institution I received' doses of insulin varying from 20 units a day up to 100 units a day, and the quantity; finally settled down to 50 units in the 24 hours. During the eleven weeks of my stay in hospital the improvement continued slowly, but fairly surely, all the time. My weight increased 'to 11 stone 6 pounds, and I was enabled to have a moderately satisfactory diet, though, of course, the carbohydrate portion was cut down to the narrow lim't. of 30 grammes, otherwise an ounce, a day, and the total caloric value was about 1760. To give the reader some idea of what such a diet means I may state that the British Army ration has a caloric value of 4962, and that the ordinary person's daily food represents a value of 3500 to 4000 calories though they could very well live and thrive on less in most cases. In fine, I think I can say quite definitely that insulin saved my life. It has not registered a "cure 1 ' so far, and, possibly, in my case it never will, but it will apparently enable me to carry on without any unbearable hardship which, after all, is rather better than pushing up the daisies.

Not a Bare Disease. At one time I thought diabetes a very rare disease; now I know that it is very much more common than most people think I have spoken with many persons on the subject, and it is clear that there is much ignorance both about the disease and about insulin, the most hopeful remedy so far. What is the prime cause of diabetes? —I don't know, and neither does anybody else.

Is insulin a cure?— This has never been claimed for it, I believe. The injection of insulin merely supplies something that the body needs which is not being supplied in sufficient quantity normally. It is hoped that a course of insulin may possibly give the organ vitally interested a rest, and allow it to become more or less regenerated, and so able to do its duty. This is only a hope, however, and whether it is correct or not remains to be proved. If correct, and the insulin could be discontinued, a "cure" could certainly be claimed. If not correct, then it is obvious that the treatment must ba continued indefinitely.

Do all diabetics need insulin ?—Luckily for them, no. Probably the majority of cases are mild ones, and a few minor modifications of their diet would be all that is necessary to enable them to live safely and comfortably. The trouble is that a person might have diabetes in a mild form and never know it until it had progressed to a comparatively severe form. The remedy for this possibility is to treat oneself to a thorough overhaul by a doctor at least once a year. It would be a sensible birthday present. What is the insulin treatment like, pleasant or unpleasant?—lt cannot be called pleasant. In fact, it becomes a distinct bore, but you put- up with the unpleasantness because of the benefits received. Insulin has to be injected with a hypodermic syringe, and in my own case this means three punctures a day. Apart from the minor unpleasantness of the "stab," the dose usually has the result of making the seat of the puncture tender—it feels like a bruise—for about twelve hours, or more, after. On© rather wishes that one had as many arms, or legs, as a centipede, so that it would take a long time to get round them! Danger in Over-dosing. Can a person administer insulin to himself ?—Yes, the job is easy for anyone who can muster up enough resolution to stick a needle into himself. Indiscriminate administration, or use not under medical direction, might be cx(Poatinnßd at foot of aesfc column.)

ceedingly dangerous. Insnlin i s "heap big medicine," and an overdose might have disastrous effects, resulting in an in memoriam notice appearing in the papers. In finding the correct doseage fairly elaborate blood-sugar estimations, etc., have to be made, which are not matters for the layman. However, given the quantity to use, the actual administration is a small matter ami is very little real bother. \V hat is the dose of insulin ?—Thisdepends entirely on the patient. There is no hard and fast rule. One man might do well on ten units a day, another might need six or seven times that amount to get a similar result. \V hat is the cost of insulin ?—I gather that the Australian-made insulin is supplied to the hospitals at threepence a unit. According to English advertisements a bottle containing 100 units is sold for 17s 6d, or two anyonetenth pence a unit. The cost of treatment obviously depends on the amount one has to use. No doubt insulin will get cheaper m the near future. It is of vital importance that its cost bo lowered as soon as possible. Under the present circumstances one can infer that anyone reoeivjng insulin treatment is either-n. rich man or is getting it aid ' foj ; the man TRith the average salary could not afford to buy ,t if he had to use it in any large quantity. The time must come when insulin is made in this Dominion. We slaughter over 8,000(XX) animals yearly here and all of these am a potential source of the material which at present is wasted. We rn &£ Z&Sgfoz «- With diabetic luw a sporting ctancc rt* SSStStSiT-lr 1