Doyen of diabetes

Professor Timothy Welborn has been at the forefront of diabetes research and practice since the mid 1960s, from the Busselton Study to AusDiab and the formation of Diabetes Australia

When asked if he believes he has made a difference after a lifetime researching and treating diabetes, Professor Timothy Welborn’s answer is simple.

“When I was a young man I thought I could solve it all”, he tells the MJA. “At least lives were saved in Busselton, I think.”

Understatement is one of Professor Welborn’s talents. The Busselton he refers to is the sleepy Western Australian fishing village that became the centrepiece of one of the world’s longest population studies.

Every 3 years from 1966 until 1978, the entire adult population of Busselton was poked, prodded, weighed and measured in a bid to assess the impact of common chronic diseases in Australia, such as heart disease, stroke and diabetes.

Even after 1978, the participants were brought back together in the 1980s and 1990s for reassessment, culminating in a massive database which not only threw light on the health of Australians, but also put Busselton and its populace on the medical map.

“It’s certainly true that survey attendees had a survival advantage”, Professor Welborn says of the Busselton participants, once again understating the impact he and his colleagues had.

The 76-year-old endocrinologist started making waves early in his professional life, pioneering the concept of insulin resistance when he was writing his PhD thesis at London University in the late 1960s.

“I was doing my PhD on levels of insulin in men. By serendipity I got a good assay. I had to look at the normal range of insulin in healthy young contemporaries.

“I did a glucose tolerance test on myself and a young Canadian registrar who was the same age, weight and height as me and his was 10 times higher than mine. And that was when the question of insulin resistance was raised”, he says.

“That led to the burgeoning notion that insulin resistance might be the ultimate risk factor for cardiovascular disease.”

When Professor Welborn and his family returned to his home town of Perth, he realised that what his PhD research needed was a population study.

A meeting with Busselton GP Dr Kevin Cullen, who was keen to create a centre of community health and prevention, followed, and, together with biochemist David Curnow, epidemiologist Michael McCall and CSIRO biostatistician Norman Stenhouse, the team set up shop in May and June of 1966.

“We had no money”, Professor Welborn says. “We raised $5000 from three drug companies, and $5000 from Westpac.

“We needed to use local volunteers and the community spirit was incredible. We asked the local hospital to allow their staff to take 3 days off to help us.

“We saw the entire adult population of Busselton in 2 weeks ­— 3500 subjects, one every 2 minutes.”

By the end of the fortnight, the researchers had data for an amazing 91% of the Busselton population aged over 21 — 3350 participants.

Professor Welborn trained as an endocrinologist at Hammersmith Hospital in London from 1963 to 1966, after being introduced to diabetes as a starry-eyed 22-year-old resident at Royal Perth Hospital.

“I had a very commanding registrar”, Professor Welborn recalls. “She said to me: ‘Timothy, your job is diabetes; at the end of every working day, you will go to every ward and look at all the diabetics’ charts and make corrections’.”

Later, at Hammersmith he learned the ethos of the clinician–researcher.

“It was almost unspoken”, he says. “You did your clinical wards but research was always the buffer. Nobody did not do research.”

These days Professor Welborn is in “leisurely” private practice in Perth, is an emeritus consultant at Sir Charles Gairdner Hospital and is a clinical professor of medicine at his alma mater, the University of Western Australia.

He has been at the forefront of diabetes visibility in this country for decades, serving as president of the Australian Diabetes Society from 1982 to 1984 and overseeing the amalgamation of what he describes as “the warring tribes” of diabetes organisations to form Diabetes Australia in 1986.

“I can look back and say that I never wanted to be bored”, he says. “There are always challenges in private practice and I never get complacent. You can only do your best.”