Bittersweet: diabetes, insulin, and the transformation of illness

Abstract

Bittersweet: Diabetes, Insulin, and the Transformation of Illness By Chris Feudtner (Chapel Hill: University of North Carolina Press, 2003) (290 pages; $29.95 cloth). The recent upsurge of diabetes mellitus in the American population has heightened the public's awareness of the challenges that persons with diabetes face daily as they and their families struggle to adjust their lives to the disease's demands. Chris Feudtner's Bittersweet: Diabetes, Insulin and the Transformation of Illness comes at an opportune time, for it poignantly illustrates, through the use of 60 years of correspondence between Dr. Elliot Joslin and his patients, what it meant to live with the disease before and after the discovery of insulin. Feudtner captures the excitement and joy of physicians, patients, and families over the discovery of life-saving insulin; a discovery that arrived like a thunderbolt in their lives. Prior to the availability of commercial insulin, in 1922, the life expectancy of a newly diagnosed juvenile diabetic was three restricted and pathetic years of life. Although the miracle of insulin transformed diabetes from a lethal acute to a complex chronic disease, the life of a person with diabetes was fraught with complications. Physicians struggled to understand and prevent severe problems from occurring. Insulin allowed people with juvenile diabetes the freedom to live and mature into productive and responsible adults, and some women with the disease could even experience motherhood. However, within a decade after the initiation of insulin therapy, such complications as retinopathy, renal failure, and cardiovascular disease restricted and threatened their lives regardless of how strictly they adhered to the prescribed diabetic regime. Feudtner, a pediatrician and an astute historian, spins his evocative and probing history of diabetes through the eyes of patients. This method is possible because of the availability of Dr. Elliot Joslin's personal sixty-year collection of patient records and correspondence, now housed in the historical archives of the Joslin Diabetic Center in Boston, Massachusetts. Joslin, an 1895 Harvard Medical School graduate, became interested in diabetes research while a Yale undergraduate. After studying abroad and interning at Massachusetts General Hospital, he set up a private practice in 1898 with ties to Harvard's Medical School. Interested in combining medical research with the practice of medicine, Joslin began a detailed record of his diabetic patients that included the progress of their medical conditions and personal and social information on their lives. …

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