Diabetes (Genes & Disease), by Toney Allman

When one deals with health in the contemporary world, it is natural ponder the relationship between genes and disease. In the case of Diabetes, there is a bit of contradictory information regarding the relationship between genes and the disease and this book finds itself struggling to deal with that information. In particular there is a tension between the reality that there are a lot of genes that appear to be partly related to diabetes and its origins and development and the importance of the so-called thrifty gene that appears to provide for survival benefits in times of food scarcity but deep trouble in times of plenty, which appears to be a remarkable enough aspect of genetic vulnerability to Diabetes that it takes up several pages of this book, and deservedly so. Aside from the contradictory aspects of the role of genes in diabetes, the real issue with this book is that the author serves as a booster of the use of stem cells without a proper explanation of the ethical and moral issues with it, seeking to bolster advocacy by pointing to all the (self-interested) people who seek in stem cell research the solution to problems without a proper reflection on the ramifications of such treatments.

Among the more problematic aspects of this book, albeit one that is not immediately obvious, is that the author to the book is not really particularly qualified to write this book. Her Master’s degree is an MA in clinical psychology and she appears to be more interested in engaging in the rhetoric of framing issues relating to science and diabetes rather than speaking in a clinical and scientific (much less moral) fashion about them. I am not sure to what extent this particular issue is just related to this volume or if it can be found throughout the series as a whole, as this is the first book in the series I remember having read. This does not make the book worthless. Indeed, if one has little understanding of the various diseases that make up what is called diabetes, this book certainly provides accessible and basic information that can be worthwhile to know. The main issue of this book, as is so often the case, is that the book falters when it makes the transition between providing information, which it does competently, to moving into an advocacy perspective, where the book is less successful. Given the difficulty that authors have in doing advocacy well, it is striking how often authors seek to act in such a way.

In terms of its contents, this book is a relatively short book of just over 100 pages in core material. The book begins with a discussion of what a diagnosis of diabetes means (1). This is still an area of considerable difficulty, in that some of the symptoms of diabetes can occur considerably before a patient is viewed as having diabetes, and that standards for diabetes have become more strict over time concerning blood sugar levels and the like. The second chapter then discusses the treatment of diabetes, which is also generally decent as far as the advice is concerned about diet, exercise, and medicine (2). At this point the book takes its turn from discussing the diseases of diabetes and moves into a discussing of genes. First, there is a discussion of genes and DNA that is pretty basic (3), and designed for someone who does not know about the material well. Then there is a discussion of genetic engineering and the creation of human insulin, which is at least mildly concerning (4). This is followed by a discussion of genes and how they relate to type 1 (5) and type 2 (6) diabetes, where the author appears to be at pains trying to stay up-to-date on the information relating to genes and how they relate to the two types of diabetes. The author then gets into dicey territory ethically speaking with discussions on gene therapy as a cure for diabetes (7) as well as the possibility of stem cells serving as a cure for diabetes (8) in allowing for the possibility of creating enduring beta cells to replace those destroyed by the diseases. The book then ends with notes, a glossary, bibliography, suggestions for further reading, picture credits, an index, and information about the author.