Milestones in Joslin Care and Education
1917: Dr. Joslin's his first textbook, The Treatment of Diabetes Mellitus, was published, beginning a long tradition of Joslin publishing. The next year Dr. Joslin published the first comprehensive guide for patients, which becomes a national bestseller—A Diabetic Manual for Doctors and Patients. To date, there have been 14 editions of the professional text and 13 editions of the patient book.
1922: Dr. Joslin oversees the administration of the first trial of insulin in New England, which is administered by his associate Howard Root, M.D. Before insulin, the only treatment was a “starvation diet,” which included fasting and large quantities of fat (75 percent of diet) and few carbohydrates (4 percent). Joslin’s nurses were taught to give insulin and to calculate the calories needed to balance patients’ diets with their insulin doses. These “wandering nurses,” the forerunners of today’s diabetes nurse educators, visited patients throughout New England, sometimes living with a family for several weeks to teach parents how to care for their young children with diabetes. This was the era when the needles to inject insulin were large and had to be sharpened on pumice stone; and syringes were made of glass and had to be boiled and re-used.
1925: Dr. Joslin starts a camping program for children with diabetes. In 1932 he became the Medical Director of the Clara Barton Camp for Girls with Diabetes and in 1948, the Elliott P. Joslin Camp for Boys was established.
1937: Joslin clinicians help fine-tune the use of the newly-discovered long-acting insulin.
1949: Priscilla White, M.D., a founding member of Joslin Clinic, introduces the White Classification of Diabetic Pregnancies. This pioneering concept classifies patients according to their level of risk and tailors their treatment protocol accordingly.
1950s: A few years after the first successful kidney transplant at the Peter Bent Brigham Hospital, four diabetic patients from Joslin undergo kidney transplants.
1956: Inpatient teaching unit opens, realizing Dr. Joslin’s dream of building a friendly and supportive facility where patients could be treated and educated individually and in groups on how to manage their diabetes.
1971: Home monitoring of blood glucose becomes possible with development of blood glucose meters.
1974: When Dr. Priscilla White joined Joslin’s practice in 1924, only 56 percent of babies born to diabetic mothers survived; 50 years later when she retired, that rate had jumped to more than 90 percent.
1978: Weekly pump clinic started to meet the needs of patients on pumps.
1993: The landmark study—the Diabetes Control and Complications Trial (DCCT)—proves conclusively that tight control of blood glucose (made possible by home monitoring) with multiple injections of insulin versus then-standard treatment of two injections of insulin per day significantly reduces or delays the risk of eye, kidney and nerve disease.
1995: Joslin clinical researchers identify blood glucose levels that will limit kidney disease.
1998: Joslin Vision Network—a telemedicine technology developed at Joslin—found to produce images of eye’s retina just as accurately as standard equipment, but without having to dilate the pupil. Remote sites across the United States can now access Joslin’s expertise in diabetic eye disease diagnosis and treatment.
2001-2005: Joslin begins outreach to multicultural populations at high risk for developing type 2 diabetes. Targets awareness campaign to African Americans, and launches Latino Diabetes Initiative and an Asian American Diabetes Initiative, both of which offer a bilingual clinic at Joslin Clinic.
2002: The Diabetes Prevention Program (DPP) study shows people with elevated blood glucose levels who are at risk for developing type 2 diabetes can reduce their risk by 58 percent through sustained modest weight loss and increased moderate-intensity exercise, such as walking 30 minutes daily.
2003: Joslin "Care Ambassadors” (case managers) make a significant difference in helping children control blood glucose.
2003: Online discussion boards are started for teens and their families to learn more about living with diabetes from professionals and from each other.
2003: JoslinCare is now the official way of expressing the kind of diabetes care for which Joslin has been renowned the past 100 years. JoslinCare provides each individual patient with a customized pathway of state-of-the-art care: sequenced diabetes education, personalized nutrition and exercise prescriptions, and lifelong health management programs.
2003: Research shows that obese adults with diabetes or pre-diabetes who lose seven percent of their body weight and do moderate-intensity physical activity for six months improve their major blood vessel function by about 80 percent, reducing their risk of heart disease (Osama Hamdy, M.D., Ph.D.)
2003: Joslin publishes the first Chinese-English book (Staying Healthy with Diabetes: A Guide for the Chinese American Community) with culturally specific tips for diabetes management.
2004: Camp Joslin celebrates its 80th anniversary.
2005: Joslin publishes nutrition guidelines for people with type 2 diabetes or prediabetes who are overweight or obese. The guidelines are designed to combat the epidemic of type 2 diabetes with effective nutrition strategies for this population. Those who follow the guidelines should see an improvement in insulin sensitivity, a reduction in visceral fat, improved lipid levels and weight loss.
2005: Lloyd M. Aiello, M.D., steps down as Director of the Beetham Eye Institute; his son, Lloyd Paul Aiello, M.D., Ph.D., steps into the Director role after two years as Associate Director.
2006: Joslin is selected as one of nine teams nationwide to participate in a landmark program from the Robert Wood Johnson Foundation to design and test ideas for how consumers can use information technology to better manage their health and navigate the healthcare system.
Page last updated: April 25, 2014