In this week’s blog, Lauren Young discusses her PhD research on the the history of diabetes in post-war Northern Ireland:
Diabetes, both Type 1 and Type 2, became increasingly common throughout the twentieth century in western countries. This was due to the epidemiological transition from infectious to chronic illness, changing western diets and the ‘new public health’ that emerged internationally from the 1970s.[1] The number of people living with diabetes in Northern Ireland currently is 100,000, 5.7% of the population.[2] Further afield, since 1996, the number of people diagnosed with diabetes in the UK has risen from 1.4 million to 3.5 million, according to research carried out by the organisation Diabetes UK. By 2025, diabetes prevalence in the UK is estimated to rise to five million.[3]
In today’s society, diabetes is becoming a huge health concern along with other chronic conditions that need to be managed by the patients themselves. Diabetes Type 1 was relatively rare until the post-war period. Type 2 has become increasingly common as a result of increased life expectancy and lifestyle change in recent years. Indeed, diabetes is now considered epidemic.[4] As Martin Moore outlines (in relation to England), in the post-war period outpatient clinics came to be viewed as particularly beneficial for providing regular and long-term interactions between doctor and patient to work on managing their condition better. In line with broader trends towards patient-centred therapy, lifestyle and risk factors, from the 1970s particular emphasis was placed on patient education and self-management.[5]
My PhD thesis will provide the first historical research project on diabetes in twentieth-century Northern Ireland, with an emphasis on the post-war period. It will also provide an insight into what it was like to live with diabetes from the patient’s point of view. Medical history today is bombarded with works on the successes of twentieth-century medicine and medical men. But there are very few, if any, accounts of the experience of medicine from the patient’s perspective. Historians now should be working to bring through the patient voice in medical history, which is exactly what my thesis aims to do.
This thesis is an oral history project. In order to gain an insight into the patient experience of living with diabetes in Northern Ireland, I will interview patients who were diagnosed in the years following the establishment of the National Health Service in 1948. I will interview people of various ages and aim for an equal balance of both male and female participants. By interviewing diabetic patients who were diagnosed and treated during the twentieth century, I aim to find out how diabetes services and treatments changed through time after the establishment of the NHS. This will cover areas such as the change from injecting with syringes to the introduction of popular insulin pens in 1985, as well as the advancements in diagnosis techniques in hospitals. Questions will also cover areas such as the patient’s relationship with their doctor and diabetes healthcare team.
A key theme in this research will be finding out what it was like to live with diabetes in twentieth-century Northern Ireland. Interview questions will acknowledge the difficulties of living with diabetes and the social stigma that was attached to the condition at this time. For example, a story I heard of recently revealed that a man who was diagnosed with diabetes in the 1960s felt the need to hide his diagnosis from his employer. Following an episode of hypoglycaemia in the workplace, his employer found out about his condition and this resulted in the patient losing his job. I aim to find out if this was a common problem for patients in Northern Ireland, as well as other social circumstances attached to their diagnosis. Whilst this research looks at the history of diabetes in Northern Ireland through the eyes of the patient, I will also record interviews with both doctors and diabetic nurses. The aim of this is to learn more about how their practice of treating diabetes changed during the twentieth century, as well as how their relationship with patients changed through time.
Lauren Young is a history PhD student at Queen’s University Belfast. Her research focuses on the history of Diabetes in twentieth-century Northern Ireland, with a particular emphasis on the changing patient experience of treatments and services since the establishment of the NHS in 1948.
[1] Alexander Mercer, Infections, Chronic Disease and the Epidemiological Transition: A New Perspective (University of Rochester Press, 2014), 5.
[2] “Diabetes in Northern Ireland,” Diabetes UK, (accessed 8th August 2019) https://www.diabetes.org.uk/In_Your_Area/N_Ireland/Diabetes_in_Northern_Ireland
[3] “Diabetes in Northern Ireland”.
[4] Robert Tattersall, Diabetes: The Biography (Oxford: Oxford University Press, 2009), 84.
[5] Martin Moore, “Food as Medicine: Diet, Diabetes Management, and the Patient in Twentieth Century Britain,” Journal of the History of Medicine and Allied Sciences 73, no. 2 (March 2018), 153.
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