Insight from the Past Offers Hope for the Future of Diabetes
Patient Focus | This year, the American Diabetes Association celebrated its 75th year at ADA.15 in Boston, MA. In the midst the scientific presentations, the Association sponsored a more personal, anecdotal, and sometimes nostalgic press conference that showcased four panelists who have been involved with diabetes for more than 50 years.
Robert Ratner, MD, FACC, the panel moderator stated that this year’s anniversary suggests that the researchers and physicians would like reflect on the last 75 years—the problem with this, he said, is that “there’s a limited amount of people who we could contact who have been involved in diabetes 75 years ago.” The guests included Daniel Portre Jr., MD, who has conducted diabetes research for over 50 years; Fred W. Whitehouse, MD, who boasts more than 4 decades of treating patients with diabetes; Michael Brownlee, MD, who has lived with the disease for 48 years as a physician and researcher; and Kathryn Ham who, remarkably, has lived with type 1 diabetes for 78 years.
The group reminisced about the early years of diabetes treatment. Dr. Whitehouse—who was a contemporary of Elliot Joslin, MD—spoke of a time when the only treatment available for his type 1 diabetes patients was cow or pig insulin, and the only treatment for hypoglycemia was orange juice. Remembering how he would help his diabetic brother test his urine over the flame of the stove in their mother’s kitchen, it “seems very crude,” compared with today, he said.
Dr. Brownlee also reflected on the limitation of the early days of diabetes treatment. When he applied to medical school, as a type 1 diabetic, he wasn’t expected to live into his 40s or early 50s. He “wouldn’t be able to practice medicine for a full lifetime,” and so schools were hesitant to accept him into their programs. “They’d rather give the spot to someone with a normal lifespan. Fortunately, advances in diabetes research and treatment have made those old statistics obsolete,” he said.
While their experiences stressed the large scope of the history of diabetes, their primary message in the session rested on the importance of incremental change—especially clinical research that may not initially seem to contribute to the body of knowledge in a meaningful way. Dr. Portre cautioned, “You’ve got to be patient, because [research] takes a long time to go from basic research to clinical impact… For example,” he said, “the drugs we use now to treat diabetes were first studied 30 to 40 years ago.”
He went on to say that there is usually a 10 to 20 year lag between the discovery of the idea and the use of it to build new ideas that can be studied in the lab and the population. “The first step of basic research is very important. It may seem very far removed” and “criticized as irrelevant” to treating the patient, especially when it can take 20 years to find out that the new approach doesn’t work. Researchers have “disappointments and eureka moments.” The disappointment moments are important, too, he stressed. “You can’t have one without the other.”
Ms. Ham, who has been seeking treatment at the Joslin center for 59 years, reflected on shrinking needle sizes, new kinds of insulin, and the new technology, such as digital blood glucose meters. “I really appreciate all the work that has gone into the research and development of diabetes. With diabetes, you really have live a disciplined life,” she said. “You can live a very full and healthy life if you follow the direction of your medical people. I feel fortunate to have taken advantage of all the advancements.”
Dr. Whitehouse remains optimistic about the future, even if the advances in diabetes treatment takes some time: “We’ll be up on cloud someday, looking down, saying, ‘That’s how we did that.’” It may have taken awhile, he said, but they will have done it.
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