Inspiration for the future

This is just as well, as in Europe it is largely estimated that 1 in 20 of us has diabetes, and many will need insulin immediately, or at some point in their life journey with the condition. Despite political and economic decisions which prevent universal usage, insulin remains one of the discoveries of the century.

However, science does not stand still for long. While we were praising the miracle treatment that was insulin therapy other problems arose. ‘The era of coma as the central problem for people with diabetes gave way to the era of complications’ (Joslin). Those complications are vast and, together with the obesity epidemic, we continually strive to find answers to emerging diabetes complications and a cure for this debilitating condition.

Some of these problems as we now know are psychological and this edition reports on attitudes to health and lifestyle from adolescents with type 1 diabetes in Portugal (Serrabulho), and also attitudes of UK practice nurses as they take on additional diabetes case management in the community (McDowell).

Then there is the relatively new phenomenon of ‘diabesity’ (Finer) – a description of people with both obesity and diabetes. Here, two authors describe quite different approaches: O'Connell discusses the need to manage obesity in a multidisciplinary team, while Kennedy investigates bariatric surgery in Europe as a treatment for morbid obesity and diabetes.

In the last 90 years things have moved on quite dramatically with regard to diabetes treatments and knowledge. In marking the great discovery which is insulin we can draw inspiration of what might be achieved in the next few decades – stem cell research, transplants, immunotherapy and pharmacological agents, diabetes screening and prevention strategies. Hard work is still needed on every possible front. But take some time in the year of 2012 to marvel at what has already been achieved.