Bittersweet: The transformation of diabetes into a chronic illness in twentieth-century America

Chris Feudtner, University of Pennsylvania


What happens when an individual's experience with a chronic illness intersects with the advent of remarkably effective medical therapies? For countless American "juvenile" diabetic patients during this century, their lives have been shaped by a series of new medical interventions that have transmuted diabetes from an acute and lethal disease into a chronic and often debilitating entity. Through successive cycles of transmutation--wrought first by diet, then insulin, antibiotics, and other therapies--medical treatment has thoroughly reworked juvenile diabetes' biological manifestations, largely substituting the immediate danger of diabetic coma for the long-term sequela of blindness, renal failure, and circulatory disease. The once-natural history of diabetes has been transformed into an evolving "transmuted" course of illness, one marked by success and frustration, progress and irony. While the biological transmutation of juvenile diabetes has been a powerful influence in the lives of patients, their experience with the disease has been affected by other forces as well. Moving beyond a story of diets and drugs, this dissertation seeks to understand how medical therapy combined with broader aspects of twentieth-century American social history and cultural values to transform the experience of chronically-diabetic patients. Drawing on a vast archive of medical records and letters exchanged between patients or family members and the staff of the Joslin Clinic in Boston, this dissertation traces the experiences of these particular patients and those who cared for them as diabetes was transmuted and transformed into a chronic illness during the twentieth-century.

Subject Area

Science history|Surgery|American history

Recommended Citation

Feudtner, Chris, "Bittersweet: The transformation of diabetes into a chronic illness in twentieth-century America" (1995). Dissertations available from ProQuest. AAI9532174.