Book review: Diabetes: The Biography

Following his retirement from clinical practice in 1998, Robert Tattersall intended to write a “definitive, exhaustively referenced, history of diabetes” for doctors. However, when editors at Oxford University Press asked Professor Tattersall to write a biography of diabetes that would appeal not only to the medical profession but also to a wider general readership, he seized the opportunity.

Diabetes: The Biography will appeal to both clinically qualified and lay persons with an interest in diabetes. Tattersall starts this historic journey of diabetes in 1500 BC when Papyrus first described the classic diabetes symptom of polyuria. His engaging style guides the reader through early experimentation with novel diets and extracts, unravelling the complex role of the pancreas in diabetes. Controversy over the discovery of insulin by Banting, Best, Macleod and Collip is presented with objective perspective, along with the enormous contribution made by the pharmaceutical industry. It is astounding to believe that when metformin was first introduced in 1958 it was received unenthusiastically, having initially been used to treat influenza. 

Tattersall’s biography provides the reader with illuminating and fascinating stories to help explain the influence of renowned clinicians in changing the lives of people with diabetes. For example, in 1923 Dr Sanderson believed the low level of sophistication in general practice meant “whatever may be the benefits conferred on the diabetic by insulin, there seemed little doubt that it bade fair to bring many practitioners to a premature grave so multitudinous, bewildering and worrying were the problems involved”. Ninety years later, for many clinicians the prospect of initiating a patient on insulin is unchanged. 

Well researched and interesting statistics are presented throughout the text. In stark contrast to recent figures, in 1875–1895 only 272 cases of diabetes were identified among 27721 medical inpatients. It is also incredible to believe that in 1964 when Miles Laboratories first introduced the “dextrostick” it refused to directly supply this to people with diabetes. 

Readers may be interested to learn that Tattersall’s own research was pivotal in demonstrating the positive impact of empowering people with diabetes to measure their own blood glucose levels. Perhaps this fact is discreetly presented when considering the estimated UK prescribing cost for blood glucose strips was £118 million for the period November 2002 to October 2003 (Farmer and Neil, 2005). 

Tattersall’s obvious interest in medical history has created a biography of diabetes that will appeal not only to a wider readership, but also to those with specific expertise. His research provides us with an historical perspective, refreshing insight and challenges the reader’s knowledge of diabetes. Perhaps one of the most pertinent reflections within the book is provided by one of Tattersall’s own patients, likening diabetes to living with a tiger; “If you look after it, and never turn your back on it, you can live with a tiger. If you neglect it, it will pounce on you and rip you to shreds.” In summary, this is essential reading both for clinicians and for people with diabetes. 

Author: Robert Tattersall
Publisher: Oxford University Press, Oxford
ISBN13: 978-0199541362