A question of control? : managing diabetes and its professionals in Britain, 1910-1994

• Main Author: Moore, Martin D.
• Published: University of Warwick 2014
• Subjects: 900; RA Public aspects of medicine
• Online Access: http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.606210

This dissertation examines the evolution of British diabetes management over the over the course of the twentieth century. It argues that through a series of technological, political, institutional and epistemological changes, British diabetes management came to centre on the bureaucratic discipline of professional medical labour by the early 1990s. That is to say that, by the end of the period discussed here, medical professionals and state bodies united in heralding care protocol, guidelines and audit systems as the best means to improve the quality of medical care, and, through improved risk management, to improve national health outcomes by extension. In undertaking such a study, however, this thesis looks to do more than simply add a new perspective to the growing literature on the history of diabetes. Instead, it both expands current understandings of the history of twentieth-century chronic disease control strategies in Britain, and historicises and reformulates existing literature on the emergence of clinical governance-style mechanisms for managing British medicine. In bringing these literatures and perspectives together, therefore, it is able to gain new insight onto the multiplicity of approaches taken to public health in the twentieth century, and to see structured and reviewed medical care as a framework that gradually emerged out of changing professional and political activities during the previous century. As a condition seen from the mid-century onwards as a model chronic disease, diabetes mellitus provides an excellent lens through which to read these histories. The history of its management and prevention, moreover, will only grow in importance over the coming decades as prevalence rates for the condition itself continue to rise into the twenty-first century.