'Conditionally Healthy and Able to Work': Diabetes Prevention, Care and Research in the German Democratic Republic (GDR), c. 1949-1990

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Abstract

This thesis seeks to chart the development of a comprehensive system of diabetes care in a socialist state, the German Democratic Republic (GDR). There have been few seminal studies to date on chronic diseases using state socialism, and in particular the GDR, as a contextual base. The thesis serves to highlight the fact that chronic diseases were acknowledged, treated and rationalised behind the Iron Curtain. It uses diabetes as a case study to shed light on what exactly the state socialist response was to a rising, and potentially debilitating, disease. It is therefore primarily concerned with what makes diabetes management in the GDR, first, distinctly state socialist, and, second, unmistakably East German. Following the Second World War, a radically different approach to health developed out of the rubble in the Soviet Zone and later GDR. The principle of social hygiene, firmly within the realm of epidemiology, focused on the economic and social causes of disease. It allowed for the previously marginal diabetes to become a focus of attention when East German diabetologists discovered an unexpectedly higher incidence of the disease than previously assumed. Aware that diabetes could lead to complications, the addition of a Marxist-Leninist productionist critique meant that the prevention of invalidity and keeping people in work were of paramount concern, leading to the development of an elaborate screening programme and a prevailing attitude of 'prevention first'. When the diabetologist responsible for the creation of the GDR's showcase '(Central)Institute for Diabetes', Gerhardt Katsch, proclaimed that diabetics were 'conditionally healthy and able to work', it chimed with the expectations of a regime of which he and his ideas were now a part. Surveying the entirety of the GDR's lifetime, this thesis begins by looking at the introduction of new institutions catering to the needs of diabetics, from outpatient specialist polyclinics to a boarding school for diabetic children, and examines the influences underpinning them. The thesis is structured chronologically with embedded themes in a deliberate attempt to reveal how broader events, including autarkic economic policies, diplomatic relations and political upheaval came to shape the novel, East German approach to diabetes.

Keyword(s)

Chronic Disease; Diabetes; GDR; History of Medicine; State Socialism

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