Type 2 diabetes means insulin resistance, by definition. Most of us are very familiar with the concept.
But it wasn't that long ago that people didn't know that. They thought that all types of diabetes were caused by too little insulin, and what we now call Type 2 was called "mild diabetes" or "adult-onset diabetes."
It was considered mild because people with that form of diabetes can survive without injected insulin and rarely go into diabetic ketoacidosis (DKA). (A type 2 whose diabetes has advanced to the point that almost no insulin is produced reacts the same as a type 1). What they didn't know was that people with type 2 diabetes actually have more insulin than normal in the early stages of disease. And the reason they didn't know this was that tests to measure insulin levels accurately had not been developed.
Then along came Rosalyn Sussman Yalow, who died on May 30 at the age of 89. In the 1950s, she developed a radioimmunological method to measure the levels of hormones and other compounds that are found in minute quantities in the blood. One of the first compounds she focused on was insulin.
Yalow and a colleague, Solomon Berson, noticed that insulin remained in the bloodstream longer when patients had previously received insulin injections. They hypothesized that injecting insulin caused the body to produce antibodies against it, and they developed an assay using antibodies and radioactive iodine to measure the exact amounts of insulin. This method is now called RIA (for radioactive immunoassay), and is still used, although other methods for measuring tiny amounts of various compounds have been developed since then..
When they tried to publish the results of their work on detecting insulin, medical journals rejected the papers because the work contradicted the dogma of the day. Yet Yalow went on to be awarded a Nobel Prize for her work (her colleague, Berson, had already died by that time, and the Nobel Prize is never given posthumously).
She would later say, "Initially, new ideas are rejected. Later they become dogma if you're right."
Despite the rejections from mainstream medical journals, Yalow and Berson continued their work and were able to show that people with adult-onset diabetes did not usually suffer from a lack of insulin but from what came to be known as insulin resistance, which made the insulin less effective. And this led to the development of drugs designed to treat the insulin resistance rather than just increasing insulin levels even further.
Those of us who have type 2 diabetes owe a large debt to Yalow. She faced opposition not only because the original work was rejected by the establishment but also because she was a woman. She was initially rejected from graduate school and given a job as a secretary instead. It was only the labor shortage during World War II that gave her an opportunity to get her PhD in physics.
Yet she didn't give up and go home to bake cookies for her family, as some of her male colleagues would have preferred. She persisted. And she achieved great things.
We should use her example as inspiration to persist in our blood glucose control efforts. Sometimes type 2 diabetes seems overwhelming. When we also need to lose weight, or to maintain weight loss we've already achieved, and we're constantly faced with temptations in a carbohydrate-overloaded society, it's tempting to throw up our hands in despair.
But we must persist. We won't get a Nobel Prize for living to be 95 with no complications. But if this remarkable woman could achieve so much in a hostile world, so can we.
Don't give up. Control your diabetes. Persistence pays off.
Published On: June 06, 2011