Brothers’ Diabetes Spans History of Insulin

Bob Cleveland wondered if he’d live when he went to the hospital as a 5-year-old. In 1925, hospital visits were made for dire reasons.

“Insulin was discovered just two years earlier, in 1923,” he says, adding that he used to test his blood glucose with a urine test. “Depending on the color of the [test] results, it indicated if you had a little sugar or a lot of sugar in your system. Based on that, my mother had to increase my insulin intake or decrease it.”

Bob Cleveland’s three siblings thought they had lucked out until his brother Gerald Cleveland was diagnosed with type 1 at 16 years of age.

“That was 73 and a half years ago,” the 90-year-old Gerald says. “The two of us represent a unique family picture, with such a long time having diabetes.”

Gerald says that at first it was depressing to know that he had to live with diabetes.

“But I found out later that I was healthier in general than people around me,” says Gerald, who worked as a teacher and later as a superintendent of schools for nearly 40 years. He was widowed in 2002 after 62 years of marriage to his late wife Mildred, and he has two children, Linda and Roger.

The Secret to Longevity

Both brothers attribute their longevity to the healthy lifestyle required to control their diabetes. They also credit their mother for her care and dedication to their diabetes management.

“Taking care of yourself encompasses proper eating, and in my case, insulin and exercise,” says Bob, a retired accountant, who has two children, Marilyn and Neil, with Ruth, his wife of more than 58 years.

“My one main goal is to get as much exercise as I possibly can. We go to Florida in the winter to be outside. I do a lot of bicycle riding—not the indoor stationary type. I do anything I can to stay active. We have a motor home. All our married lives we’ve traveled the country over several times. We did rugged exercise in our earlier years in the Rocky Mountains.”

“The fact that I’ve kept in reasonably good health all my life is because of careful control,” says Bob, who recently renewed his driver’s license. “I feel that I’ve been well cared for over the years.”

Gerald Cleveland says research and advances in diabetes management are also to thank for his longevity.

“My reason for living and continuing to live is due to research,” he says. “I think one day they’re going to have a cure.”

Technological Advances

Gerald Cleveland used Regular insulin in the early days of his diabetes.

“It was about 100 times less strong than the current insulins,” he says. “What now would last me 30 days, I’d take in one day back then.”

The brothers took insulin from glass syringes with needles that were ground on a whetstone for periodic sharpening.

“My father sharpened our needles at the outset,” Bob says. “It was done once or twice a week. Each day, my mother would take the needles and the syringe and boil them up to sterilize them. You used the same needle for an indefinite period of time until it had been sharpened so many times that the needle wore down, and we had to get a new one. Today, we throw them away. Times have really changed.”

Blood glucose testing was unheard of when the Cleveland brothers were first diagnosed. In the early days of testing, people used a metal holder on the test tube and held it over a Bunsen burner, Gerald explains.

“I had an old enamel pot with a wire grate in it with a hole in the middle, so the tube could sit in boiling water. I’d boil the water, put the tube in it with the Benedict’s solution, put a drop of urine in it, and boil it for a couple minutes. It was tedious and time consuming.”

Now Gerald uses an Accu-Chek Comfort Curve glucometer.

“A little drop of blood on a little thing that shoots out from a tube, and in about two seconds, you have an answer.”

Today, Bob Cleveland says, it’s a marvelous thing compared to the first testing methods.

“You can get fast and accurate readouts of where your blood glucose is,” Bob says. “I check mine about five times a day and adjust my insulin accordingly. Today my blood glucose was 71 mg/dl in the morning. Normally I’d take faster-acting insulin in the morning and at dinner.

But I didn’t take any insulin at all today until dinner due to the exercise I was getting during the day.”

A Message From Experience

Gerald Cleveland urges others with diabetes to “pay attention to their health” and to not take chances.

“You can have a pretty liberal life today, as long as you follow certain basic regimens,” he says. “Don’t forget you’re under a certain set of rules, and that if you violate them, you’re going to have problems.”

Gerald says his sensitivity to high and low blood glucose levels is less acute with age.

“At 90, I’m lucky to be alive,” he says. “But I’m better off than 90 percent of the people here where I live at the retirement community.”

Gerald still wakes in the middle of the night to test his blood.

“I can lift 5-pound weights. I can twist and turn and bend, and I’m physically quite strong. I’m able to get around, I’m able to drive a car. I can still read and hear without hearing aids. I’m in better condition than most people my age.”

Bob Cleveland says others should listen to their doctors and adhere to a good food intake and exercise regimen.

“It’s a whole lifetime behind me. I may be 86 years old on March 10, but I’m ready to keep going. I feel kind of awesome!”

The Regimen of Real Insulin Veterans

Bob Cleveland’s daily insulin regimen includes 2 units of NovoLog in the morning and at dinner, plus 18 units of Lantus at bedtime. Unlike the old days, his syringes today are a quarter of an inch long.

“One of these needles today would easily fit inside the needles my mother used to inject me. They were an inch or more long. They’re so small today that there’s no pain from it.”

Gerald Cleveland takes about 10 units of Lantus at bedtime and about 3 units in the morning. He also uses a Humalog pen, dialing up anywhere from 2 to 8 units for meals, based on carbohydrate counting.

Gerald Cleveland says, “I watch my fats and my salt and the other ingredients pretty well,” he says. “My main concern is carbohydrates.

Right: An insulin kit like the one Bob Cleveland used in the 1920s, and a syringe and insulin vial from the late 1920s.

All photos courtesy of Eli Lilly and Company

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