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At the beginning of the 20th century, diabetes sufferers mostly tended to be middle-aged and overweight, and could live tolerably well with the disease for a couple of decades, but when it occasionally struck younger people, it could be fatal within a few months. The development of insulin in the early 1920s dramatically changed things for these younger patients. But that story of the success of modern medicine has tended to dominate public perception, so that diabetes is regarded as a relatively minor illness. Sadly, that is far from the case, and diabetes can produce complications affecting many different organs.
Robert Tattersall, a leading authority on diabetes, describes the story of the disease from the ancient writings of Galen and Avicenna to the recognition of sugar in the urine of diabetics in the 18th century, the identification of pancreatic diabetes in 1889, the discovery of insulin in the early 20th century, the ensuing optimism, and the subsequent despair as the complexity of this now chronic illness among its increasing number of young patients became apparent. Yet new drugs are being developed, as well as new approaches to management that give hope for the future.
Diabetes affects many of us directly or indirectly through friends and relatives. This book gives an authoritative and engaging account of the long history and changing perceptions of a disease that now dominates the concerns of health professionals in the developed world.
Diabetes: the biography is part of the Oxford series, Biographies of Diseases, edited by William and Helen Bynum. In each individual volume an expert historian or clinician tells the story of a particular disease or condition throughout history - not only in terms of growing medical understanding of its nature and cure, but also shifting social and cultural attitudes, and changes in the meaning of the name of the disease itself.
List of illustrations ix
1 The pissing evil: defining the disease 10
2 Unravelling the role of the pancreas 31
3 Insulin: a force of magical activity 52
4 The dark ages 79
5 Treating long-term complications 98
6 Adult-onset diabetes and tablets at last 115
7 At the laboratory bench 136
8 The pharmaceutical era 159
9 Diabetes becomes epidemic 178
Further reading 219