In the grand scheme of things, insulin itself is a relatively new medicine. Invented in 1923 by the team of Frederick Banting and Charles Best in Canada, insulin was an instant miracle. Before its invention, children who were diagnosed with Type 1 diabetes slowly (and sometimes not so slowly) starved to death. The only option open to parents was to bring their children with diabetes to special in-patient clinics where they were kept on very low calorie diets, the thought being the less sugar a child's body had to process, the longer he could live with diabetes. The longest a child usually lasted, even in these horrific conditions, was about two years.

Once insulin was available, the way diabetes was viewed changed instantly. Rather than a quick death sentence, diabetes became something a child could live with. Parents were then faced with the reality of raising a child with a chronic, incurable disease. Although this was clearly a miraculous choice considering that just a handful of years earlier their child would have died, it created its own challenges. Needles were large, painful, and reusable, causing children to develop sores at injection sites. There was no real understanding of how to track blood sugars or what to do about them. Food intake was still strictly monitored and enforced (sugar was a no-no).

Insulin was keeping kids alive. However, because there was only one kind of long-acting insulin and no way to measure blood sugar on a regular basis, the disease still had a severe impact on any life: Frequent lows and highs, erratic blood sugar levels, and complications such as kidney failure and blindness were the norm.

Slow Progress and a Few Clues

As children lived with diabetes and doctors studied the patterns of the disease, they began to realize some facts. Children whose parents worked to keep blood sugars in control as much as possible lived longer and healthier. Most of the Type 1 patients who have received the Eli Lilly Award for living fifty years or more with diabetes recall parents who worked diligently to keep them in some kind of stable range, even without the tools available today. Some parents served smaller meals all day to match the peaks they could see in insulin in the body (just from watching their child's daily patterns). Others painstakingly gathered urine regularly to dip it to check glucose levels. While they didn't have the tools or the know-how yet, these pioneering parents were laying the groundwork for what today is called “tight control.”

Most parents now marvel at these stories. As tough as it is today, it's hard to imagine how tough it was, even as recently as the early 1980s.