Cheating Destiny: Links to Web Sites About Diabetes

A character-driven account, written with barely controlled anger, of what diabetes is, what it is like to be diabetic and how and why the medical community is failing to deal effectively with this widespread and as-yet-incurable condition. Hirsch (Riot and Remembrance, 2002, etc.), a former reporter for the New York Times and the Wall Street Journal, is diabetic and has a young diabetic son. Diabetes is, he says, the most common and costly chronic illness in America and "our most daunting public health threat"-our health-care system, he notes, is designed to treat acute, not chronic, illnesses, especially not those with such physical and emotional complexity. Hirsch distinguishes between insulin-dependent type 1, formerly known as juvenile diabetes, and the more common insulin-resistant type 2, once called adult-onset diabetes. He tells many individual stories: the outreach efforts of a black community-health worker in South Carolina; the economic problems of a doctor trying to provide good care to his diabetic patients; the pros and cons of one physician's extreme diet regimen. There's even a chapter of heroic survivor tales. Interwoven in this narrative is Hirsch's personal experience of diabetes, and most movingly, the story of his young son, Garrett, who was diagnosed at age three, and for whom he battles to obtain the best possible care. Any parent will empathize with the ups and downs of this struggle. Hirsch is not optimistic that a cure will be found any time soon, but he expresses hope that research will find better means of prevention and better therapies. He contends that the burden of diabetic care needs to be shifted from costly physicians who lack both the time and theeducation to do the job, to nurse specialists, nutritionists, educators, even pharmacists. Given the tools and the training, he insists, most patients can take control of their health and cheat destiny. A provocative amalgam of staunch advocacy, personal experience and investigative reporting.

If anybody could write a book on diabetes, it would be Hirsch. Diagnosed with Type 1 diabetes at 14, he has a diabetologist brother who is also diabetic, and his 3-year-old son was also diagnosed while Hirsch worked on this book. He is up-to-here with passion and commitment, and it shows. That doesn't get in the way of his mission to demonstrate the impact--personal, economic, scientific--of a disease that many say is the fastest-spreading epidemic of the century. Calliope music is almost audible as he describes the circuslike atmosphere of the 2004 Scientific Sessions of the American Diabetes Association, for which each pharmaceutical company's exhibit booth seems bigger and grander than the last one's. Hirsch segues from there to the heart-wrenching account of a toddler whose world suddenly becomes framed by needles, blood draws, and roller-coaster reactions for which the child will be held accountable, though Hirsch shows, through a thorough history of the science of diabetes, that it is the illness that controls him. Hirsch has an insider's candor speaking about life with diabetes, the sensitivity of the parent of a child with a chronic illness, and the skill of a good journalist reporting on the medical, social, economic, and scientific details of what was once called "the wasting disease."

From Library Journal

Hirsch (Riot and Remembrance: America's Worst Race Riot and Its Legacy) is a former New York Times reporter who has lived with Type 1 diabetes for 25 years. Additionally, his brother is a diabetic, and his own child was recently diagnosed with the disease. Not surprisingly, then, this work is written with both craft and passion. Hirsch details the sad, short lives of diabetes sufferers before 1922, when insulin first became available for patient use, and describes the limitations and unintended consequences of insulin therapy. Despite advances in glucose monitoring and insulin delivery systems, controlling blood sugar remains an uncertain enterprise. With more than 20 million Americans having diabetes, Hirsch argues that the search for a cure, possibly through stem-cell research, is increasingly urgent. The figure of 20 million, however, includes all forms of the disease. Ninety percent of diabetics have the Type 2 variant that comprises "America's biggest epidemic." In fact, most of his narrative deals with Type 1. The sensationalist title may thus be misleading to prospective readers. Nevertheless, this book makes its case with skillful writing and emotional impact. Recommended for most libraries.

Kathy Arsenault, Univ. of South Florida at St. Petersburg Lib.
© 2006 Reed Business Information.

Hirsch, a type 1 diabetic, agonized when his three-year-old son began exhibiting the symptoms of diabetes. More, he was prompted to take a look at diabetes and how it is treated in this country and the possibility of finding a cure for this ravaging disease. What he finds isn't always encouraging. Skillfully combining journalistic expertise with his personal story, Hirsch, a former reporter for the New York Times and the Wall Street Journal (Hurricane: Riot and Remembrance) asks the editor of a hugely popular Web site about the quality of care for diabetes in this country. The response: "It stinks." Hirsch details the physical complications that arise for insulin-dependent type 1 diabetics and health insurers' reluctance to fully reimburse relatively low-cost education for diabetics, resulting in their need for high-cost diagnostic testing and hospital care. Some of Hirsch's reporting uncovers a common blame-the-patient attitude in doctors.
The author also covers the controversial studies of Denise Faustman, whose groundbreaking research has produced promising results in mice, and the stem-cell research of Douglas Melton. Overall, this is an informative and moving analysis of a disease with a death rate that, high as it is, the author says is underreported.
16 pages of b&w photos. (Nov. 8)