Diabetes, Insulin, and the Transformation of Illness

By Chris Feudtner

320 pp., 6.125 x 9.25, 36 illus., 6 tables, 15 figs., notes, bibl., index

  • Paperback ISBN: 978-1-4696-2373-3
    Published: January 2015
  • eBook ISBN: 978-0-8078-6318-3
    Published: January 2004

Studies in Social Medicine

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One of medicine's most remarkable therapeutic triumphs was the discovery of insulin in 1921. The drug produced astonishing results, rescuing children and adults from the deadly grip of diabetes. But as Chris Feudtner demonstrates, the subsequent transformation of the disease from a fatal condition into a chronic illness is a story of success tinged with irony, a revealing saga that illuminates the complex human consequences of medical intervention.

Bittersweet chronicles this history of diabetes through the compelling perspectives of people who lived with this disease. Drawing on a remarkable body of letters exchanged between patients or their parents and Dr. Elliot P. Joslin and the staff of physicians at his famed Boston clinic, Feudtner examines the experience of living with diabetes across the twentieth century, highlighting changes in treatment and their profound effects on patients' lives. Although focused on juvenile-onset, or Type 1, diabetes, the themes explored in Bittersweet have implications for our understanding of adult-onset, or Type 2, diabetes, as well as a host of other diseases that, thanks to drugs or medical advances, are being transformed from acute to chronic conditions. Indeed, the tale of diabetes in the post-insulin era provides an ideal opportunity for exploring the larger questions of how medicine changes our lives.

About the Author

Chris Feudtner is a pediatrician at The Children's Hospital of Philadelphia, where he focuses on ways to improve the quality of life for children with complex chronic conditions and for their families.
For more information about Chris Feudtner, visit the Author Page.


"A consummate study in irony, in the classical sense of the dramatic unfolding of tragic consequences from apparently benign events."--British Journal for the History of Science

"For anyone who has lived with diabetes or who has tried to manage it, this book provides resonating and arresting insights."--Medical History

"Dr. Feudtner's book focuses on the history of diabetes through the observations of people who have lived with it."--The New York Times

"Provides insight into diabetes from the pre-insulin era through the 1950s. . . . Highly recommended."--Choice

"Open[s] up new perspectives--not just about treatment of diabetes, but about the care of everyone who is ill. . . . I would set a book like Bittersweet at the core of my course on doctoring."--Journal of the American Medical Association

"[A] superb, gem-like book. . . . What is especially appealing about this informative and provocative tour de force is that, like a cut jewel, its many sparkling facets illuminate throughout--variously, a biographic sketch of Dr. Joslin and some of his colleagues, a compact history of diabetes, an overview of the significance of disease transformation, and an insightful discussion of medical practice and health policy. . . . Every physician would benefit from reading it."--Journal of the National Medical Association