Diabetes Rising: How a Rare Disease Became a Modern Pandemic, and What to Do About It

by Dan Hurley

Written by award-winning investigative journalist Dan Hurley, Diabetes Rising is a gripping expose of the quest for a cure for the disease that afflicts hundreds of millions of people around the world. Hurley chronicles today’s diabetes epidemic—how the disease has grown so dramatically, why the American Diabetes Association focuses its attention on just a small handful of available treatments, and why the research being done today doesn’t look beyond accepted types of treatments. Just as Eric Schlosser’s Fast Food Nation uncovered the sordid details leading to an epidemic of obesity, Dan Hurley uncovers the hidden truths of what is being researched—and even more importantly, what is not. Diabetes Rising explores both Type 1 and Type 2 diabetes, one of the leading causes of deaths in the United States. With ground-breaking research and compelling stories seen through an investigative, historical, and narrative lens, Diabetes Rising couples big-picture insight with intimate reporting. The book yields riveting insight into the struggle between the pervasive malady and the medical community’s ongoing search for answers. Informed but not dominated by the author’s own experience as a Type 1 diabetic, Diabetes Rising grants exclusive access to new studies, innovative treatments, and determined patients. Hurley’s sharp, entertaining, and provocative read will change how readers understand diabetes, and the cultures, conditions, and medical climates in which it thrives.

Genres: Nonfiction, Health, Science

336 pages, Hardcover

First published January 1, 2010

Reviews

[Pete Nuffer · Rating 5 out of 5]

Dan Hurley takes an investigative reporter stance on tracing the history of diabetes with a personal insight to the disease, having lived as a Type 1 Diabetic himself for decades. As a father of a two year old with Type 1, I found the information presented both educational, devastating, and frustrating.
In terms of the educational value for anyone who deals with this monster on a daily basis, I learned more about the history of the disease and the particulars of management (one line comments like "That's when we first learned a breakfast bolus needed to be larger than any other bolus of the day" rang true - if only our endocrinologist had told us that originally when going on the MM Paridigm pump for our daughter's management, the hyperglycemia episodes we would have avoided!) than I had in the entire year and a half of talking to doctors and reading message boards.
As for devastating, especially for parents who are not diabetic, it is incredibly hard to read about what a low feels like, and hear a grown man's frustrations vocalized as he realizes that his personal management will never be quite enough, and that he is one episode away from death. The story of his daughter having to revive him after a bad hypoglycemic episode was heartbreaking for me, as I imagined my own sweet daughter grown up and having to face that, much later in her life. Equally frightening are the statistics and the realities of the disease, especially for those who are diagnosed at a young age. Granted, much progress has occurred even in the last twenty years so statistics are bound to change, so there is hope in that. I still am amazed that as recently as 1993 it was debated that you may be able to get away with checking glucose levels only twice a day and not micromanaging the problem. The associated risks of low episodes are certainly worth if it you can maintain a diligent checking schedule and avoid or reduce the risk of long term complications.
Now for frustrating. The chapter on solutions. The biological solution section made sense - these things take time. It may be twenty years before a real CURE is found. I get that. What has me red faced and angry is that the artificial pancreas EXISTS today, and that all indications are that it's management capabilities far exceed the manual management we parents and those with Type 1 go through in terms of maintaining normal levels. In the EU, a Medtronics pump already is on the market that will cut delivery when the glucose monitor senses an approaching low. Why do we not have this here in the US? Why, when the technology, the algorithms, the formula's are all available, is this not on the market. FDA squabbling and inefficiency, Corporate litigation fears, and general scientific foot dragging in the search of perfection over IMPROVEMENT. It's good enough. It should be release TODAY. Sure it's not a cure, it's not perfect, but the initial tests Mr. Hurley describe seem to indicate that this technology would drastically reduce3 the margin for error. People may not trust computers, but if I have a calculus problem to work out, you damn well better believe I'm going to pull out a scientific calculator as opposed to a sheet of paper. Type 1 Diabetics and those who love them should be up in arms, in the streets, demanding action.
At any rate, a fantastic book, highly recommended, and at the end of the day has given me so much valuable information in the fight for my daughter's life, and perhaps, even a glimmer of hope that someday it will be at least EASIER.

[Timothy Finucane · Rating 4 out of 5]

If you think you know all you need to know about Diabetes and what causes it, I strongly recommend you give this book a read and realize just how complex the subject really is. This rising disease goes beyond the simple "Fat Man's" disease it has been so commonly labeled. Dan Hurley, a type 1 diabetic himself, takes a deep dive into the statistics regarding the rise of diabetes, then drives right into the variety of possible causes currently under research, and finally concludes with a in depth discussion about what possible cures exist or may be coming in the near future. I guarantee you will walk away from this one with a much better understanding of the many issues faced by today's diabetics.

[Chris · Rating 2 out of 5]

This book interested me as someone with type 1 diabetes who appreciates information about my condition that is more sophisticated than the average diabetes magazine or blog but less technical than scientific journal articles. However, it didn't really meet that need for me. Let me tell you why.

(Before I go on, I should say that I skipped the chapters purely about type 2 diabetes: 4, 11, and 13).

First, it doesn't make sense to write a *book* (as opposed to a blog or some other more "updatable" medium) about the current state of diabetes knowledge and research, since it changes so fast. For example, these days the continuous glucose monitors (CGMs) that Hurley piloted are in wide use, the first round of the TRIGR study was inconclusive (see https://www.trigr.org/documents/Press...), the first automated "artificial pancreas" system has been approved by the FDA, etc.

Second, as a historian, I had all kinds of trouble with Hurley's claims about the historically increasing rates of diabetes. (He even acknowledges that one of the researchers he talked to cautioned him against making such claims...but he does it anyway.) (He also doesn't always report statistics by type of diabetes, so it's hard to evaluate what's really going on, even during periods for which we have good statistics.) Historians of medicine such as Elizabeth Lane Furdell (author of Fatal Thirst: Diabetes in Britain Before Insulin) have found plenty of evidence of diabetes in previous centuries, although it's impossible to talk of incidence or prevalence rates for eras in which statistics weren't kept, clinical definitions of the various types of diabetes were unspecified, public health agencies didn't exist, and ordinary people may not have seen doctors for their diabetes (in the absence of insulin, they couldn't do much for you anyway).

I did encounter a few useful ideas in the book. I wasn't familiar with the Accelerator Hypothesis, but that may well explain why I developed type 1. The problems with and concerns about teaching people to manage their own diabetes using "tight control" (pp. 31, 51), which I was taught to do from Day 1, are fascinating. Finally, I very much appreciated the response when Hurley asks artificial-pancreas programmer Marc Breton why "controlling blood sugar is so maddeningly complicated even though it involves just two variables, insulin and sugar level." Breton replied, "The glucose you measure with a CGM was accurate 15 minutes ago. The insulin you take does not start acting for 20 minutes, has a peak of action around 45 minutes, and continues to act for up to 3 hours. So you are acting on out-of-date data, and you're using a mode of action that will only kick in much later on. It's like you're driving a car down a winding road--but you aren't able to see that the road turned until you are 15 yards past it, and turning the wheel will have no effect for 200 yards more. If you're driving a car like that, you'd better have a good map" (p. 198). Indeed.

[Melissa · Rating 4 out of 5]

Ever since I heard Dan Hurley on NPR's Talk of the Nation and he said that frequent low blood sugars was the symptom of a HEALTHY diabetic, I knew I had to read this book, if only out of appreciation for him spreading this public service announcement. He talks about living with type 1 in a way I've been waiting for for years: realistically, and recognizing that complications, especially severe lows, are unavoidable if you are keeping your sugars in a healthy range.

So, as a type 1, the book made me feel seen--recognized. But what did I learn?

First, I learned about how insulin was created (it involved a lot of dead dogs. And Canadians!). It also answered a lot of my questions about how people used to live with diabetes (before insulin, through starvation diets!). I also learned all about type 2, and actually am convinced that it is a lot more difficult to take care of than type 1 is. But, mostly, I learned that no matter how many studies link so many different factors to the incidence of diabetes, no one has any real clue what causes type 1! I really don't have any of the risk factors. My momma had me when she was young, she breast-fed me, no one else in my family has it, etc etc. However, 3 people in the cul-de-sac where I grew up DO have type 1! Personally, I'm betting it's environmental factors above all else.

Who knows? I sure don't, and I guess it doesn't matter that much to me. I've already got the diabetes, and it's not going anywhere. An automated pump/continuous glucometer sounds nice, but my hemoglobin a1c is 5.2 even though I'm on multiple daily injections still. So what I got out of this book may not be very concrete, but it definitely gave me food for thought and taught me a thing or two.

[Trux · Rating 2 out of 5]

Disclosure: I only read the very beginning of this book and decided not to finish it. I felt led to believe that it would be an objective piece of stellar journalism, but from the get-go it seemed really biased and relied on manipulation of facts.

Example: in the prologue he talks about the rate of new diagnoses of type 2 diabetes in kids growing by enormous leaps in recent years, then tries to impress upon us how crazy this is when compared to the decrease in DEATHS caused by cancer and heart disease. Sorry, dumbass: if you need to rely on comparing apples to oranges right out of the gate, then I can't trust you, and don't want to ever try to persuade other people to recognize how huge of a problem diabetes is by quoting from things I learned in this book because they might be like, "oh, you got that from that Diabetes Rising book? Well, that's just a bunch of propaganda filled with fallacious arguments."

I'm sure there are a lot of redeeming qualities in this book, but I don't have time to be suckered into finding them.

[Susan · Rating 5 out of 5]

This book describes the rise of diabetes, both types, over the last century until it now has the status as a virtual pandemic. It discusses possible causes of the rise and medical approaches to the disease. As one of my daughters has suffered from type 1 diabetes since age 10, this topic is of particular interest to me. I found the book immensely readable, and both fascinating and troubling. My only frustration with it is that, in some of the statistics presented (not all, but some), it is not always clear whether the numbers apply to type 1 or 2, or both. Aside from that, it's a superb work on a topic that deserves far more attention.

[Gina Rheault · Rating 4 out of 5]

Very well written, like a mystery, a whodunit of medicine. "The sugar", my grandmother called it. Diabetes is much less publicized than cancer but probably as dangerous, needs good PR//advocacy campaigns just as AIDS and breast cancer have had in their heyday. Its almost as if you have diabetes, especially Type 2, you want to be in the closet about it. The history of multiple hypotheses on diabetes basic nature is a classic in medical history, which shows how elusive it is to 'cure' a complex disease whose underlying mechanisms are barely known. Put diabetes up there with AIDS and cancer, and wonder that more is not done to prevent it. Great job, Dan Hurley.

[Heather · Rating 5 out of 5]

Awesome, informative, insightful. I recommend this to everyone, not just those affected by diabetes. From the 'history of' to the 'reasons why' sections, this book is just great.

[Michelle · Rating 5 out of 5]

Wow-- what an eye-opener. Dan Hurley presents some amazing facts. I was especially educated about the growing Type 1 diabetes epidemic and surprising environmental/dietary connections.

[Karen · Rating 4 out of 5]

Fascinating and frustrating.

[Denise Spicer · Rating 4 out of 5]

This 2010 book is interesting and informative. It covers the history of the disease and its rise from ancient times to the present, the invention of insulin, the pros and cons of tight glucose control, some possible causes (cow’s milk, obesity, pollutants, low levels of Vitamin D, and high levels of hygiene). The author discusses possible “cures” -- surgical, artificial, and educational.

[Renae · Rating 3 out of 5]

I am very interested in diabetes because my husband is Type 1 diabetic. We've been blessed that in our almost 8 year marriage he's only had a very serious low one time (resulted in an ambulance ride to the hospital) however we have dealt with several other complications related to his diabetes (eye issues, he just had a kidney transplant a year ago).

Mostly I was hoping I'd learn 'new' ways to help prevent the disease in our 3 children.

I must say I was disappointed in the lip service paid to breastfeeding. It seems like such a cheap (aka FREE) and easy way to help prevent the disease in those who are at risk. It really bothered me that the doctors interviewed went as far as to say they won't recommend it as a prevention in order to prevent 'guilt' in parents of diabetics. Something needs said about the subject!! I worked very hard to breastfeed all 3 of my children. I'm distressed that with most medical groups saying not breastfeeding raises the risk as much as 33% that they'd play such lip service to it.

Overall the history and the startling rise of diabetes diagnoses was very interesting.

[Debra]

Diabetes is a cruel, cruel disease no one deserves. As a society we should be more concerned about the pandemic rise of both T1 & T2 and other autoimmune diseases in the last few decades. This is a good read for anyone regardless of if you've been touched by the disease or not. Scientific information is delivered in an easy to understand way. Different theories about the cause/prevention are shared. Different approaches to a cure are shared. I hope in my life time scientists will find both the cause and the cures for T1 and T2.

[Jennifer · Rating 4 out of 5]

Somehow I have been lucky to not know of any friends or family who have diabetes. When I started working at a free health clinic, I was amazed at the huge percentage of our patients who have this disease, so wanted to learn more. This book is an interesting history, likening it to the plague or polio. It reminds me of the game "Clue" because Mr. Hurley provides different hypotheses (so maybe Colonel Mustard did it in the library with a candlestick) but in the end you are left guessing who, where and what happened.

[Rick · Rating 5 out of 5]

Great book that covers the history of the disease, the methods we have used to combat it, what might cause it, and what we are doing to fight it/cure it. For those looking for clear-cut answers, this is not the book for you. Go tilt against windmills elsewhere. This is reporting at its best and does offer hope. I know I will be taking a lot of vitamin D from now on and see how that helps my sugar.

[Carolyn · Rating 5 out of 5]

This book is a MUST read for understanding the problems today. The simple definitions of Type 1 and Type 2 diabetics are becoming blurred because of a change in the numbers of people being diagnosed today and it's link to rising weights across ALL body types. There are other factors involved. Plus this book details the risks, the meds, the inside story etc. I learned a LOT.

[Nathan · Rating 4 out of 5]

This is the first diabetes book that I've read, and I thought it was outstanding! Right up until the conclusion, where I thought he should have ripped a whole variety of people and entities a new one. But instead, he dashed off a two-page call to action. This is serious stuff, and things really, really must change! The stats are staggering.

[Dahlia · Rating 3 out of 5]

interesting, though not compelling. his theories on the causes of the rise of diabetes are not backed up with enough data to be convincing, though i do think i'm going to start taking a vitamin D supplement. the book makes some good points, but nothing i haven't seen elsewhere.

[Amy]

Only about 1/3 in on this when it needs to be returned to inter-library loan. Need to put it aside anyway, because, while much of it is not new to me, I'm feeling overwhelmed by it. When it interferes with sleep, maybe the timing is wrong, right?

[Arleta · Rating 3 out of 5]

Very informative. Great summary of the current research.

[Kate (lkatemm on Storygraph) · Rating 4 out of 5]

There were a few sketchy parts in the potential causes section, but I think Hurley does a nice job of talking about history, interesting theories and the latest possible diabetes treatments.