Elliott P. Joslin
Encyclopedia
Elliott Proctor Joslin, M.D. (6 June 1869 - 28 January 1962) was the first doctor in the United States to specialize in diabetes and was the founder of today’s Joslin Diabetes Center
. He was the first to advocate for teaching patients to care for their own diabetes, an approach now commonly referred to as “DSME” or Diabetes Self-Management Education. He is also a recognized pioneer in glucose management, identifying that tight glucose control leads to fewer and less extreme complications.
and educated at Leicester Academy
, Yale College
and Harvard Medical School
.
Joslin first became interested in diabetes while attending Yale, when his aunt was diagnosed with the disease. At the time, diabetes was considered an obscure disease, with no cure and little hope. He made diabetes his focus while attending Harvard Medical School, winning the Boylston Society prize for work later published as the book The Pathology of Diabetes Mellitus.
His postgraduate training was at Massachusetts General Hospital
, and he also studied with leading researchers in metabolism from Germany and Austria before starting a private medical practice in Boston’s Back Bay in 1898.
regarding the benefit of carbohydrate- and calorie-restricted diets. The patients were admitted to units at New England Deaconess Hospital, helping to initiate a program to help train nurses to supervise the rigorous diet program.
Joslin included the findings from 1,000 of his own cases in his 1916 monograph The Treatment of Diabetes Mellitus. Here he noted a 20 percent decrease in the mortality of patients after instituting a program of diet and exercise. This physician’s handbook had 10 more editions in his lifetime and established Dr. Joslin as a world leader in diabetes.
Two years later, Dr. Joslin wrote Manual — for the Doctor and Patient detailing what patients could do to take control of their disease. This was the first diabetes patient handbook and became a best seller. There have been 14 editions of this pioneering patient handbook, and a version is still published today by the Joslin Diabetes Center
under the title The Joslin Guide to Diabetes.
When insulin became available as therapy in 1922, Joslin’s corps of nurses became the forerunners of certified diabetes educators, providing instruction in diet, exercise, foot care and insulin dosing, and established camps for children with diabetes throughout New England.
Dr. Joslin always adopted a multi-disciplinary approach, working with nurses in education, surgeons and podiatrists for limb salvage and foot care, pathologists for descriptions of complications and obstetricians for assessment of fetal risk in diabetic pregnancy. The first hospital blood glucose monitoring system for pre-meal testing was developed under his direction in 1940, and was the forerunner of modern home-monitoring systems.
Dr. Joslin was also the first to name diabetes as a serious public health issue. Just after WWII, he expressed concern to the Surgeon General of the U.S. Public Health Service that diabetes was an epidemic and challenged the government to do a study in the town of his birthplace, Oxford, Massachusetts. The study was started in 1946 and carried out over the next 20 years. The results would later confirm Joslin’s fear that the incidence of diabetes in the United States was approaching epidemic proportions. He has been named as being, along with Frederick Madison Allen
, one of the two leading diabetologists from the period between 1910 and 1920.
In 1952, Joslin’s group practice became officially known as the Joslin Clinic
. In 1956, the office was moved to its current location at One Joslin Place in Boston. Joslin Clinic
was the world’s first diabetes care facility and today maintains its place as the largest diabetes clinic in the world.
Dr. Joslin was adamant in his position that good glucose control, achieved through a restricted carbohydrate diet, exercise, and frequent testing and insulin adjustment, would prevent complications. This was debated for decades by other endocrinologists and scientists, and the American Diabetes Association
was divided on this subject from its inception. Joslin’s approach wasn’t validated until 30 years after his death, when in 1993, a 10-year study, “The Diabetes Control and Complications Trial Report” was published in the prestigious New England Journal of Medicine. This study demonstrated that the onset of diabetes complications was delayed by tight glucose control, something Joslin had argued decades prior.
Dr. Joslin died in his sleep on 29 January 1962 in Brookline, Massachusetts
.
Joslin Diabetes Center
Joslin Diabetes Center is the world’s largest diabetes research center, diabetes clinic, and provider of diabetes education. It is located in the Longwood Medical and Academic Area in Boston, Massachusetts, USA. Among the Harvard Medical School Affiliated institutions, Joslin is unique in its sole...
. He was the first to advocate for teaching patients to care for their own diabetes, an approach now commonly referred to as “DSME” or Diabetes Self-Management Education. He is also a recognized pioneer in glucose management, identifying that tight glucose control leads to fewer and less extreme complications.
Early life and activities
He was born in 1869 in Oxford, MassachusettsOxford, Massachusetts
Oxford is a town in Worcester County, Massachusetts, United States. The population was 13,709 at the 2010 census.For geographic and demographic information on the census-designated place Oxford, please see the article Oxford , Massachusetts.-History:...
and educated at Leicester Academy
Leicester Academy
Leicester Academy was founded on March 23, 1784, when the Act of Incorporation for Leicester Academy was passed by the Massachusetts General Court as a private, state chartered institution. The charter issued to the Academy bears the bold signature of John Hancock, Governor of Massachusetts; and...
, Yale College
Yale University
Yale University is a private, Ivy League university located in New Haven, Connecticut, United States. Founded in 1701 in the Colony of Connecticut, the university is the third-oldest institution of higher education in the United States...
and Harvard Medical School
Harvard Medical School
Harvard Medical School is the graduate medical school of Harvard University. It is located in the Longwood Medical Area of the Mission Hill neighborhood of Boston, Massachusetts....
.
Joslin first became interested in diabetes while attending Yale, when his aunt was diagnosed with the disease. At the time, diabetes was considered an obscure disease, with no cure and little hope. He made diabetes his focus while attending Harvard Medical School, winning the Boylston Society prize for work later published as the book The Pathology of Diabetes Mellitus.
His postgraduate training was at Massachusetts General Hospital
Massachusetts General Hospital
Massachusetts General Hospital is a teaching hospital and biomedical research facility in the West End neighborhood of Boston, Massachusetts...
, and he also studied with leading researchers in metabolism from Germany and Austria before starting a private medical practice in Boston’s Back Bay in 1898.
Medical career
In 1908, in conjunction with physiologist Francis G. Benedict, Joslin carried out extensive metabolic balance studies examining fasting and feeding in patients with varying severities of diabetes. His findings would help to validate the observations of Frederick Madison AllenFrederick Madison Allen
Frederick Madison Allen was a doctor who is perhaps best remembered today for his work on a diet for sufferers of diabetes mellitus. Born in Iowa, he later studied medicine in California, after which time he was employed in a poorly paid position at Harvard University, before his work in New...
regarding the benefit of carbohydrate- and calorie-restricted diets. The patients were admitted to units at New England Deaconess Hospital, helping to initiate a program to help train nurses to supervise the rigorous diet program.
Joslin included the findings from 1,000 of his own cases in his 1916 monograph The Treatment of Diabetes Mellitus. Here he noted a 20 percent decrease in the mortality of patients after instituting a program of diet and exercise. This physician’s handbook had 10 more editions in his lifetime and established Dr. Joslin as a world leader in diabetes.
Two years later, Dr. Joslin wrote Manual — for the Doctor and Patient detailing what patients could do to take control of their disease. This was the first diabetes patient handbook and became a best seller. There have been 14 editions of this pioneering patient handbook, and a version is still published today by the Joslin Diabetes Center
Joslin Diabetes Center
Joslin Diabetes Center is the world’s largest diabetes research center, diabetes clinic, and provider of diabetes education. It is located in the Longwood Medical and Academic Area in Boston, Massachusetts, USA. Among the Harvard Medical School Affiliated institutions, Joslin is unique in its sole...
under the title The Joslin Guide to Diabetes.
When insulin became available as therapy in 1922, Joslin’s corps of nurses became the forerunners of certified diabetes educators, providing instruction in diet, exercise, foot care and insulin dosing, and established camps for children with diabetes throughout New England.
Dr. Joslin always adopted a multi-disciplinary approach, working with nurses in education, surgeons and podiatrists for limb salvage and foot care, pathologists for descriptions of complications and obstetricians for assessment of fetal risk in diabetic pregnancy. The first hospital blood glucose monitoring system for pre-meal testing was developed under his direction in 1940, and was the forerunner of modern home-monitoring systems.
Dr. Joslin was also the first to name diabetes as a serious public health issue. Just after WWII, he expressed concern to the Surgeon General of the U.S. Public Health Service that diabetes was an epidemic and challenged the government to do a study in the town of his birthplace, Oxford, Massachusetts. The study was started in 1946 and carried out over the next 20 years. The results would later confirm Joslin’s fear that the incidence of diabetes in the United States was approaching epidemic proportions. He has been named as being, along with Frederick Madison Allen
Frederick Madison Allen
Frederick Madison Allen was a doctor who is perhaps best remembered today for his work on a diet for sufferers of diabetes mellitus. Born in Iowa, he later studied medicine in California, after which time he was employed in a poorly paid position at Harvard University, before his work in New...
, one of the two leading diabetologists from the period between 1910 and 1920.
In 1952, Joslin’s group practice became officially known as the Joslin Clinic
Joslin Diabetes Center
Joslin Diabetes Center is the world’s largest diabetes research center, diabetes clinic, and provider of diabetes education. It is located in the Longwood Medical and Academic Area in Boston, Massachusetts, USA. Among the Harvard Medical School Affiliated institutions, Joslin is unique in its sole...
. In 1956, the office was moved to its current location at One Joslin Place in Boston. Joslin Clinic
Joslin Diabetes Center
Joslin Diabetes Center is the world’s largest diabetes research center, diabetes clinic, and provider of diabetes education. It is located in the Longwood Medical and Academic Area in Boston, Massachusetts, USA. Among the Harvard Medical School Affiliated institutions, Joslin is unique in its sole...
was the world’s first diabetes care facility and today maintains its place as the largest diabetes clinic in the world.
Dr. Joslin was adamant in his position that good glucose control, achieved through a restricted carbohydrate diet, exercise, and frequent testing and insulin adjustment, would prevent complications. This was debated for decades by other endocrinologists and scientists, and the American Diabetes Association
American Diabetes Association
The American Diabetes Association is a United States-based association working to fight the consequences of diabetes, and to help those affected by diabetes...
was divided on this subject from its inception. Joslin’s approach wasn’t validated until 30 years after his death, when in 1993, a 10-year study, “The Diabetes Control and Complications Trial Report” was published in the prestigious New England Journal of Medicine. This study demonstrated that the onset of diabetes complications was delayed by tight glucose control, something Joslin had argued decades prior.
Dr. Joslin died in his sleep on 29 January 1962 in Brookline, Massachusetts
Brookline, Massachusetts
Brookline is a town in Norfolk County, Massachusetts, United States, which borders on the cities of Boston and Newton. As of the 2010 census, the population of the town was 58,732.-Etymology:...
.