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August 24, 2016
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Diabetes and the Black Death

Ring around a rosy, a pocket full of posies...


By the time we reach adulthood, most of us know that the seemingly-nonsensical nursery rhymes of youth were sharp political snipes and sarcastic observations at the time of their composition. We know, for example, that the "ring" or "rosy" was the distinct buboe of bubonic plague, that it was believed that carrying around fresh flowers would help ward off the Plague, that the belongings of a Plague victim would be burned to try to limit the spread of the disease, and that all too many people had succumbed -- and would succumb -- to its horrors.


We've also been told that during its last outbreak, one in every three Europeans died from the Plague. If that proportion sounds familiar, it should: it's the proportion of people we expect to develop, and die from complications of, diabetes in the next half-century. The difference is that death from (untreated Type 2) diabetes is much less immediate than death from (untreated) bubonic (or pneumonic) plague, and that a person can live for years before his (Type 2) diabetes is diagnosed.


But there's another difference as well. Let me submit the theory that the European outbreaks of Plague would not have been so widespread nor so devastating had the region's primary religion been anything other than Christianity as it was understood and practiced at that time.


Why, do you ask, do I single out Medieval religion for the devastation of that particular disease? Consider the state of medical science through history: while the ancient Egyptians and ancient Greeks may not have been able to make the flea to rat to human connection, they were avid pursuers of medical information and medical science; it's even possible that the Egyptians practiced therapeutic surgery. In Muslim lands, physicians and surgeons continued to make strides in the advancement of science and medicine. Medieval Christianity, on the other hand, considered disease and illness to be forms of Divine punishment, and that seeking remedy through any means other than prayer (and later on, blood-letting) would be blasphemous.


In short, if you were sick, you brought the illness on yourself, and you deserved whatever inconvience, infirmity, deformity, or fate it brought you.


Doesn't that sound like the way a lot of non-diabetic folk think about diabetes (and hypertension, and high cholesterol, and...)?


While there is no guarantee that modern science can find a cure for (any type of) diabetes, we have learned to palliate and arrest many other diseases and illnesses relatively rapidly. Would-be plagues such as Legionnaire's Disease, H1N1, and similar pathogens have been isolated, quarantines established where needed, and a plethora of palliatives, arresting agents, and vaccines created to limit their spread and minimize their damage. On the other hand, the development of a cure for AIDS -- which while still a huge menace, is much less the immediate death sentence that it was thirty years ago -- has been hampered by the initial belief that its victims "brought the disease upon themselves" through homosexual intimacy or sexual promiscuity and "deserved what they got". Monogamous heterosexuals who had acquired the disease through blood transfusions were afraid to admit to their HIV-positive status for fear of being branded.


It wasn't until we accepted and understood that while AIDS may be more prevalent among certain segments of the population, it is not exclusive to a "socially offensive lifestyle" and that as fellow human beings, its sufferers merit medical consideration, that strides began to be made towards palliation, arrestation, and the still-elusive vaccination and cure.


Is it possible that we need to overcome "the blame game" for this "epidemic of Plague-like proportions" to merit the same level of consideration for diabetes?

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