A standard approach to managing diabetes involved checking blood sugar, controlling carbohydrates, and aiming for near-normal blood glucose levels.

“we had this standard feel about okay you're gonna check your blood sugar before each meal and at bedtime and then you're gonna eat certain number of meals that involve certain number carbohydrates and we had this fantasy that we're just going to sort of make people live in what I call the diabetes ICU which is a prescribed number of carbohydrates and timing and then we're going to sort of work towards making sure that everything was very predictable and then blood glucoses would be near normal much of the time”