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I am a physician with a diabetic son and I ordered this to see if it would be useful for him, especially, to read. I have enjoyed it and it has many bits of new information. The first 87 pages is a pretty good history of the disease and of attempts to treat it. I have one quibble as I had always believed that Frederick Allen got the idea for the “starvation treatment” of diabetes from evidence that diabetics did better than nondiabetics with the malnutrition in cities cut off during the First World War. His treatment program began in 1919 to 1921. His method, described by Hurley, was to eliminate carbohydrates from the diet. This worked to stop acidosis and glycosuria but the children became skeletal and were obsessed with hunger. The only way they could be treated was by residential centers where they could be kept from eating sugar. The method did keep some children alive until insulin came along in 1922. One of those children was the daughter of Charles Evans Hughes whose father was the Republican presidential nominee in 1916, losing to Woodrow Wilson. She lived to the age of 88 and few in her family even knew of her diabetes.

Hurley follows the lead of Michael Bliss in denigrating Fredrick Banting who, while not the learned professor that MacLeod was, had the vision to try a new tack in the search for a cure. There are other versions of the story that give Banting far more credit. Still, the history is all good. The most intersting part for me is where he gets into the mechanism for the disease, the “accelerator hypothesis” and the “cow’s milk hypothesis” and the others. They are very interesting and may hold clues to treatment and prevention. There have been other studies, one for example, with prediabetic pregnant women in which frank diabetes may have been prevented.

The environmental pathogen theory has been so overdone in other books on other subjects that it doesn’t hold much interest (Dioxin, for example, is mostly hype) but most of his theories are very interesting. The “Hygiene hypothesis” is very interesting and has been a major thread in research on asthma, another disease of cleanliness. Much of this began with the story of polio which really was a disease of cleanliness. All the way back in the 1960s, it was discovered that slum children in Mexico City all had antibodies to polio viruses but there was very little paralytic polio. Like some other viral diseases, polio was relatively harmless in early childhood but deadly in the young adult. He writes about the use of intestinal parasites, like hookworm, which have become of great interest in many autoimmune diseases the past few years. Even schizophrenia may have a worm connection.

He goes on to the various prospects for cures and explains some of the problems that beset diabetes therapy. He has several sections on the latest in potentially curative treatment, including islet cell transplant and the artificial pancreas. A short section on the use of microballoons with insulin is very interesting and I wish there was more about it. All in all, this is an excellent book for the educated layperson or the physician. Since most diabetics know more about their disease than their doctors do, every diabetic should read this book. It is highly recommended.