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Book Reviews

Diabetes Rising Book Review

Diabetes Rising is a strange name for the most readable book ever written about diabetes. But diabetes is a strange disease, as Dan Hurley shows in the book that Kaplan published yesterday.

The publisher sent me galley proofs of the new book several months ago. I’ve been waiting to review it until it became generally available.

Of the hundreds of books on diabetes that publishers and authors send me every year, I don’t usually review any of them. I’ll keep one or two of them in my bookshelf for reference, but I give away the vast majority of them, usually to my local library.

Diabetes Rising is the exception because its author has exceptional qualifications to write about it. Dan Hurley is a medical journalist who regularly contributes to the science section of The New York Times as well as to many other major publications. He earned his other relevant qualification 34 years ago at the age of 18. That’s when he got type 1 diabetes.

Broadly Researched, Up-to-Date, and Hopeful

Actually, to call this book Diabetes Rising doesn’t do justice to its broad scope. This is the main reason why I say the book has a strange name.

Just the first third of the book is about the rising epidemic of diabetes. In the second third of the book Hurley explores five hypotheses that attempt to explain the reasons behind the skyrocketing rates of both type 1 and type 2 diabetes. In the final part he explores four emerging remedies.

In tracing the rise of diabetes, Hurley covers the entire known history of diabetes. When I realized that this was where he was starting, my first thought was to race through that section. I’d read it all before, or so I thought. But those first 86 pages taught me a lot that I never knew before. And that learning was painless because Hurley is such an engrossing writer.

Even more interesting to all of us with diabetes is his next section. Here he examines five leading scientific hypotheses that offer an explanation for the recent rise in the number of us who have diabetes:
1. The accelerator hypothesis asserts that the rising weight and height of children over the past century has accelerated their tendency to develop type 1 by putting the insulin-producing beta cells in their pancreases under stress.

2. The sunshine hypothesis holds that the increased time spent indoors is reducing children’s exposure to sunlight, which in turn reduces their level of vitamin D. Reduced levels of vitamin D because of reduced exposure to sunshine are linked to autoimmune diseases like type 1 diabetes.

3. The hygiene hypothesis connects the lack of exposure to once-prevalent pathogens with autoimmune hypersensitivity. This leads to the destruction of the body’s insulin-producing beta cells by rogue white blood cells.

4. The cow’s milk hypothesis maintains that exposure to cow’s milk in infant formula during the first six months of life wreaks havoc on the immune system and increases the risk of later developing type 1 diabetes.

5. The POP hypothesis postulates that exposure to persistent organic pollutants increases the risk of both type 1 and type 2 diabetes.

Of these five theories I had given much thought to only one, the sunshine hypothesis. For the past year or so I have been writing here about how important it is for all of us to get enough vitamin D.

This section on the reasons for the rise is speculation. It makes fascinating reading because Hurley has done his research and writes so well. But it doesn’t help those of us who already have diabetes as a result of the work of one of these hypotheses or perhaps of a yet unsuspected cause.

Hurley saves his section about the remedies for our condition to the third and final section of Diabetes Rising. The four remedies — the possible cures — that he investigates are what ultimately puts a positive spin on the book:

1. The computer cure is about artificial pancreas research.

2. The surgical cure deals with bariatric surgery for type 2 diabetes.

3. The biological cure explores the search for a pill that cures type 1 diabetes.

4. The public health cure looks at options for more government regulation of the fast food industry and pushing us into more physical activity.

Diabetes Rising is available now from local and on-line bookstores. The full title is Diabetes Rising: How a Rare Disease Became a Modern Pandemic, and What to Do About It. This 312-page hardback from Kaplan Publishing in New York lists for $26.95 ($33.95 in Canadian dollars). The ISBN is 978-1-60714-458-8.

Click here to buy Diabetes Rising from Amazon.com

I found it as gripping as a well-written detective story and in fact couldn’t put it down until I had finished reading it. This book will make a thoughtful gift to anyone you know who has diabetes. Giving yourself a copy wouldn’t be a strange idea.

This article is based on an earlier version of my article published by HealthCentral.

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  • MNS at

    Have there been any studies of type I in relation to incidence of disease with respect to location in the world (places that have abundant sunshine versus not)? Daughter has type 1 since age 8. We live in Texas,she played outside and participated on swim team, she was breastfed no cows milk before 8 months. I doubt the Vitamin D/sunshine connection.

  • Jonathan at

    Doesn’t even have Bernstein in the index! What about sugar promoting immune system attack on the 64k protein? I had 2 bouts of bronchitis a year before I got Type I 25 years ago, now I’m low-carb (HbA1c 5.5%) and I haven’t had an infection in 5 years, touch wood.

  • Steve Parker, M.D. at

    Well-done review! The book sounds similar to James Hirsch’s “Cheating Destiny” of 2006. I’m sure the books would complement each other.

    Yes, the theories of diabetes causation are very interesting. But I’m caught up in treating existing diabetics.

    This is the second time I’ve heard that type 1 is increasing in prevalence. Until recently I thought it was just type 2 increasing.

    -Steve