Elliott P. Joslin

Elliot Proctor Joslin, M.D. (June 1869 - 28 January 1962) was an American diabetologist, and founder of the Joslin Clinic.

He was born in Oxford, Massachusetts and educated at Leicester Academy, Yale College and Harvard Medical School.

While still a medical student, he wrote the work that was to later be published as The Pathology of Diabetes Mellitus, which became a mainstay of diabetes treatment.

His postgraduate training was at Massachusetts General Hospital, and he also studied with leading researchers of metabolism in Germany and Austria before entering private practice in the Back Bay section of Boston in 1898. He moved to what is now known as the Joslin Diabetes Center in 1956.

In 1908, in conjunction with physiologist Francis G. Benedict, he undertook a series of metabolic balance studies examining fasting and feeding in patients with varying severities of diabetes, which helped to validate the observations of Frederick Allen regarding the benefit of carbohydrate and calorie restricted diets. Joslin initiated a program at New England Deaconess Hospital to help train nurses to supervise the rigorous diet program. The results of 1000 patients were published in Joslin's 1916 monograph The Treatment of Diabetes Mellitus, noting a 20% decrease in mortality after instituting a program of diet and exercise. The text had ten more editions in his lifetime.

A companion volume, Diabetic Manual—for the Doctor and Patient, a syllabus of diabetes education, was first published in 1918, and became a bestseller. When insulin became available as a therapy in 1922, Joslin's corps of nurses became the forerunners of certified diabetes educators, providing instruction in diet, exercise, foot care, and insulin dosing, and founded diabetic children's camps throughout New England.

Joslin had always adopted a multi-disciplinary approach, working with nurses in education, surgeons and podiatrists for limb salvage and foot care, pathologists for descriptions of complicatioins, and obstetricians for assessment of fetal risk in diabetic pregnancy. The first hospital blood glucose monitoring system for pre-meal testing was developed under his direction in 1940, and was the forerunner of modern home-monitoring systems.

Joslin's position that strict control of blood sugar levels would prevent the vascular complications of diabetes was controversial, and was finally vindicated by the Diabetes Control and Complications Trial (DCCT) in 1993.