Browsing in a second-hand book store the other day I stumbled upon a little book about diabetes . It was old and yellowing, yet “The Allen Treatment of Diabetes” looked promising. The dust jacket touted significant improvements in diabetes outcomes with this method and it acknowledged the crucial role of self-management. The endorsements from esteemed professionals assured me this was no book of quackery. Dr Hill’s motivating words were emblazoned on the cover:
“There is scarcely a disease in which good or bad treatment is so important as in diabetes; there is NO disease in which there is so much chance for the patient to do his part and to help himself by intelligent co-operation” Dr L Hill M.D.
A little into the book, patient responsibility is reinforced:
“If this treatment is to be successful, it is absolutely necessary for the patient to adhere very strictly to the diets, and to measure out everything very carefully.”
This all has a familiar ring to it doesn’t it? Sure the wording’s a bit old-fashioned but this is the same message diabetics hear every day. Managing your diabetes is in your hands, if you do the right thing all will be well, you will be “successful”.
Well here’s the kicker, this book was published before insulin had been discovered. What this book offers is the very best treatment for diabetes prior to the discovery of insulin, and that was a starvation diet.*
It’s then that I start wondering about how little has actually changed since then. As was the case almost 100 years ago, success is supposedly in our hands, if we measure our basals and boluses very carefully, measure our bgl frequently and count our carbs and exercise sufficiently then we too can have “success”. Our definition of success has changed of course, survival was what it used to be about, now it’s about low HBA1cs and being able to boast in our twitter handles & facebook that we are complication free.
Are those of us who’ve encountered complications “failures” because we didn’t self-manage adequately or are we trying to succeed at an impossible task, just like those type 1s on starvation diets many years ago? I’d really like to hear your thoughts and/or experiences on this issue, please share by commenting.
Reference: Hill, L.W. & Eckman, R.S. (1921) The Allen (Starvation) Treatment of Diabetes W.M.Leonard Boston.
*This treatment was pioneered by Dr Allen of the Rockerfeller Institute Hospital and used by diabetes pioneer Elliot Joslin. Patients at the Massachusetts General Hospital where the author, Dr Hill worked had to adhere to a starvation diet. At first they were given only clear broth or black coffee for three days moving onto a tablespoon of thrice-cooked vegetables and a nip of brandy three times a day and by day 15, graduating to 10 grams of carb and 1,200 calories (cream and butter feature as well as lean meat and vegetables).Tweet