Tag Archives: James Hirsch

James Hirsch Reviews Sonia Sotomayor’s New Book

You may know that she has type 1 diabetes.  Mr. Hirsch writes:

Sonia Sotomayor dove beneath a parked car and scrunched up like a turtle. A hospital employee finally caught her by the foot and dragged her back into the building, with Sonia fighting him every step of the way. Sonia’s diabetes was diagnosed that day. It was the first time she had ever seen her mother cry.

The year was 1962, and the vignette opens Sotomayor’s memoir, My Beloved World, the surprise blockbuster nonfiction book of the year. Named to the U.S. Supreme Court in 2009, Sotomayor has been rightfully praised as a pioneer: the High Court’s first Hispanic justice, its third female justice – and its first justice with type 1 diabetes. Though her medical condition is not always front and center in the book, it is a powerful narrative thread to her life story, a cause of anguish but also a source of motivation and ultimately triumph.

Read the rest.

Mr. Hirsch wrote a book on diabetes, Cheating Destiny, that would be of interest to anyone with diabetes.  I reviewed it a few years ago.

Comments Off on James Hirsch Reviews Sonia Sotomayor’s New Book

Filed under Book Reviews

Prediabetes Ignored Way Too Often

Only half of Americans with prediabetes take steps to avoid progression to diabetes, according to a recent report in the American Journal of Preventive Medicine.

Prediabetes is defined as:

  1. fasting blood sugar between 100 and 125 mg/dl (5.56–6.94 mmol/l) or
  2. blood sugar level 140–199 mg/dl (7.78–11.06 mmol/l) two hours after drinking 75 grams of glucose

Prediabetes is a strong risk factor for development of full-blown diabetes.  It’s also associated with increased risk for cardiovascular disease such as heart attack and stroke.  One of every four adults with prediabetes develops diabetes over the next 3 to 5 years.  The progression can often be prevented by lifestyle modifications such as dietary changes, moderate-intensity exercise, and modest weight loss.  

Investigators looked at 1,402 adult participants in the 2005-2006 National Health and Nutrition Examination Survey (NHANES) who had fasting blood sugar tests and oral glucose tolerance tests diagnostic of  prediabetes.  

The researchers estimate that 30% (almost one out of every three) of the adult U.S. population had prediabetes in 2005-2006, but only 7% of them (less than one in 10) were aware they had it.

Only half of the prediabetics in this survey reported attempts at preventative lifestyle changes in the prior year.  Only one of every three prediabetics reported hearing about risk reduction advice from their healthcare provider.

People, we’ve got to do better! 

My fellow physicians, we’ve got to do better!

The U.S. Centers for Disease Control and Prevention predicts that one of every three Americans born in 2000 will develop diabetes.  The great majority of this will be type 2 diabetes.  You understand now why James Hirsch, author of Cheating Destiny, calls diabetes America’s leading public health crisis.  I agree.

Steve Parker, M.D.

Reference:  Geiss, Linda S., et al.  Diabetes risk reduction behaviors among U.S. adults with prediabetesAmerican Journal of Preventive Medicine, 38 (2010): 403-409.


Filed under Causes of Diabetes, coronary heart disease, Overweight and Obesity, Prevention of T2 Diabetes, Stroke, Weight Loss

Book Review: Cheating Destiny – Living With Diabetes, America’s Biggest Epidemic

I read James Hirsch’s book in 2006 but never got around to reviewing it.  Better late than never?  I give it four stars per Amazon.com’s rating system: “I like it.”

♦   ♦   ♦

Cheating Destiny: Living With Diabetes, America's Biggest EpidemicIf you have diabetes or love someone who is afflicted by diabetes, you’ll benefit from this book. It’s an insider’s view into the world of diabetes, with a predominant focus on type 1 rather than type 2.  Both are covered well.

Look elsewhere for a “how-to” book on managing diabetes.  Cheating Destiny is about emotions, coping strategies, public policy, and history.  Although I’ve been treating diabetes for over two decades, Mr. Hirsch taught me a thing or two.  For instance, did you know . . . that some people with diabetes are offended if you call them diabetics? (They prefer “people with diabetes.”)  That diabetes was considered shameful years ago?  That even the preeminent Joslin Diabetes Clinic loses money and has to be supported by private donations?  That the founder of d-Life TV was a patient of the iconoclastic Dr. Richard Bernstein?  About the exciting story of the discovery of insulin by Fred Banting and Charles Best in 1922?   

The author himself has type 1 diabetes.  The heart-wrenching story of his son’s diagnosis at age 3 showcases Mr. Hirsch’s considerable writing skills. 

To counter the sad and frustrating aspects of diabetes, the book is peppered with  funny anecdotes.  Did you ever duck in to a private booth at a girlie peep show to inject insulin?  Mr. Hirsch has!  [It’s not what you think.]

One undercurrent of the book I take issue with is the implication that the medical profession somehow perpetuates diabetes or purposefully provides inadequate care, because that’s where the money is.  Why work hard to cure diabetes or prevent complications when the profession makes money off the disease and it’s complications?  I don’t see it that way at all.  It is true, however, that preventive care and cognitive medical services (as opposed to invasive procedures) are poorly funded by insurance.  That’s an economic and political problem, not an ethical one in physicians and researchers.
Full disclosure:  My defunct outpatient medical practice is mentioned in chapter five.  The author outlines my efforts to provide conscientious care to people with diabetes – mostly type 2 – despite poor funding from insurers (primarily Medicare in my practice at the time).  Poor pay for cognitive services forced me to close my office.  I found Mr. Hirsch to be a thorough and accurate researcher.

[I’m a hospitalist and health blogger now.]

Other highlights of the book are discussions of Dr. Elliott Joslin, an overweight Southern black woman (the Diabetes Queen), intimate details about the type 1 diabetes experience from the patient and family perspective, Dr. Richard Bernstein, insulin pumps, islet cell transplants, origins of the Juvenile Diabetes Research Foundation, Douglas Melton and stem cell research, research rivalries and funding, and inspirational survivor tales.

Mr. Hirsch rightfully criticizes many aspects of the health and medical fields with regards to diabetes.  Thankfully, he never suggests a sweeping government take-over of the healthcare industry.  He urges diabetics – people with diabetes – to take care of their own disease and demand improvements in the current system.

The U.S. already has 24 million people with diabetes and another 54 million with prediabetes.  Approximately one of every three persons born in the U.S. in 2000 will develop diabetes in his or her lifetime, according to the Centers for Disease Control and Prevention.

I agree with Mr. Hirsch that diabetes is “the country’s leading public health crisis,” driven by obesity and the aging of the population.”  This book will help alleviate the damages. 

Steve Parker, M.D.

Disclosure:  I bought this book at Amazon.com.  I was not paid to review it.


Filed under Book Reviews