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George Alberti: a Myriad Philip Home of Contributions to Diabetes and Beyond Diabetes Care 2017;40:1154–1158 | PROFILES in PROGRESS

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George Alberti: a Myriad Philip Home of Contributions to Diabetes and Beyond Diabetes Care 2017;40:1154–1158 | PROFILES in PROGRESS 1154 Diabetes Care Volume 40, September 2017 George Alberti: A Myriad Philip Home of Contributions to Diabetes and Beyond Diabetes Care 2017;40:1154–1158 | https://doi.org/10.2337/dci17-0006 PROFILES IN PROGRESS before marriage. Mayer-Alberti-Strasse irreverent” in an interview for The BMJ can still in found in Koblenz, but the young in 2016 (2). More Cambridge than Oxford George Alberti settled with his family in in fact. Gateshead, U.K.; U.K. citizenship was Medical students at Oxford usually granted to all in November 1946. studied Animal Physiology as an interca- The northeast of England was clearly a lated Bachelor of Arts degree, and it was hit with the young Albertidhe returned not unusual for those with academic pre- later in life from the south of England tensions to go on to do a DPhil (Oxford’s to be professor of Clinical Biochemistry PhD). George chose to do his in the Bio- and subsequently professor of Medicine chemistry Department, at an exciting and in Newcastle (see below). But as a lad he expanding time for the discipline in the crossed the River Tyne to Newcastle’s early 1960s. The department and the lab- Royal Grammar School, an institution oratory in which he worked were those of with a strong record for forwarding its Hans Krebs (one of the greatest of Hitler’s pupils to England’s top universities; gifts) (1), but George was glad not to be George went on to Balliol College Oxford. supervised by such a taskmaster. His Balliol is perhaps better known as a cradle thesis topic was “Amino Acid Metabo- of high-flying politicians and civil servants, lism in Mitochondria” (3), so already we and this may have confirmed George see the biochemical interest deviating Alberti’s (partly correct) view of his own from the then increasingly fashion- personality as “laid back, iconoclastic, able topic of gene expression and protein K. George M.M. Alberti Medawar and Pyke, in Hitler’s Gift (1), re- cord the movement out of Germany in the 1930s of world-class academic talent from within the Jewish diaspora. But among the Jewish migrants was one too young yet to show such talent, indeed a mere toddler, escaping with mother and brother as the door closed in 1939. Kurt George Matthew Mayer Alberti was born in September of 1937. His father William Peter(afterthefamily’s names were duly Young George. Left: George and older brother (Peter) with grandparents (Willi and Hedwig Lachmann) in anglicized) was a printer, and his mother Koblenz, Germany, prior to the family’s move to England. Middle: George as a schoolboy, circa 1947. Edith Elizabeth was a research physicist Right: George and his mother, Edith, circa 1962 Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, U.K. Corresponding author: Philip Home, [email protected]. © 2017 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. More information is available at http://www.diabetesjournals.org/content/license. care.diabetesjournals.org Home 1155 synthesis into intermediary metabolism, methods, pH by direct measurement, and though at that time at a cellular organelle potassium by flame photometry, to which level. George added insulin by radioimmunoas- Serendipity broke the leg of George’s say. Together these set the scene for a supervisor at that time, and George had series of investigations into the biochem- to take over tutorials of undergraduates. ical disturbance and management of ke- Oxford tutorials were intensive for both toacidosis. But perhaps it was Turner’s parties, and in this case the tutor (George) recent observation that insulin had a had to learn rapidly about insulindand half-life in plasma of 4–5 min that led to was duly hooked for life to insulin and the realization that the then current ap- George at the IDF Western Pacific Region meeting diabetes. When later asked why he chose proach to treatment of ketoacidosis (of- in Asia, circa 1980s the field of diabetes, George responded, ten 100 units as an intravenous bolus and “I chose diabetes because of my training 100 units subcutaneously) made no phar- in biochemistry and the fact that I sud- macological sense. A published letter denly found myself teaching endocrinol- from George Alberti makes it clear that Association for the Study of Diabetes ogy as a graduate student . and was maintaining intravenous lines as an alter- (EASD) (and thus editorship of Diabetolo- fascinated by the then dispute about native approach was not found reliable in gia), and the International Diabetes whether insulin acted on the cell surface routine clinical practice at the time, lead- Federation (IDF) (see below). Further Ger- or within the cell.” After this laboratory ing to the famous and career-establishing man connections were made, notably fi experience he returned to being a clinical article in The Lancet on low-dose hourly with the nascent arti cial pancreas com- medical student, with one chosen attach- intramuscular insulin injection (6). Even munity, as German science reestablished ment being to the diabetes medical unit now that is worth rereadingdthe em- itself. Industrial contacts were also devel- in Oxford. Here we get a first public phasis is as much on fluid replacement oped, two of the most fruitful being with glimpse of an interest in diabetes and clin- and careful monitoring of plasma potas- Boehringer Mannheim and with Novo In- ical biochemistry, with an article in The sium as on the insulin delivery. And in his dustri, both having strong clinical bio- Lancet on the accuracy and precision bibliography it was already number 31 of chemistry interests, the latter through ’ of the new-fangled near-patient technol- what is now over 1,100 original contributions. Lisa Heding s research and development ogy of glucose measurement, the Ames A notable temporary influence in laboratory in Bagsvaerd. Dextrostix (4). Oxford was a visiting professor, Knud This then set the scene for a diversity Clearly George’s clinical talents were Lundbaek, with whom George talked end- of activity in diabetes research and care appreciated, for his obligatory supervised lessly about diabetes and philosophy. and later beyond. An interesting com- postqualification year was on the house Later George did spend a little time with mentary from 2002 looks back on the ’ (intern) in Oxford at the Radcliffe In- him in Arhus,˚ where he established valu- impact of George s work and output in firmary teaching hospital, a post for the able and lasting collaborations on metab- the 1970s and 1980s and includes a list of selected few. But the restless scientist olites and hormones in particular with those publications he thought most im- then moved for further clinical-academic Hans Ørskov. portant (7). Also at that time, George Al- training to Boston, at Harvard in the But a career needs academic space, berti became a target for those seeking Endocrine-Metabolic Unit at Peter Bent and a base, and Oxford could not then training in diabetes clinical research from Brigham Hospital and then the Biochem- offer those in either clinical biochemistry around the world, and the Newcastle unit ical Pharmacology Unit at Massachusetts or medicine. Nick Hales, who had recently attracted an extraordinary diversity of General Hospital. His work there focused taken up the clinical biochemistry chair young fellows from Italy, the Netherlands, on mineralocorticoid activity, but he re- in Cambridge, drew George’s attention Tanzania, Cameroon, Australia, Singa- ally wanted to be with diabetes at the to the vacancy in Southampton (1973). pore, Paraguay, and elsewhere. These Joslin and indeed spent much “spare” While George rapidly established his unit people returned home and established time there, notably picking up Stu Soeldner’s in Southampton, using the automated in- internationally recognized careers, as of insulin assay (5). George (with the assay) termediary metabolite assays and adopt- course did a bunch of more homegrown subsequently returned to the Radcliffe ing the Biostator artificial pancreas, he fellows. as a clinical fellow in the Nuffield Depart- began to nurture some notable future ment of Clinical Medicine, with associ- contributors to academic diabetes. A few Insulin Therapy ated lecturer status at Oriel College. His years later a new opportunity arose with The role of insulin science and insu- sole clinical commitment was to the di- the vacancy in a similar post in Newcastle lin measurement in stimulating George abetes services. (1978), which was doubly attractive, being Alberti’s career and the translation of From that appointment we see the in- home territory and having a strong biochemical and pharmacological under- terest in diabetes flowering, notably in endocrinology unit under Reg Hall. But standings into a revolution in the man- work with Derek Hockaday, a talented George’s networking had already begun agement of diabetic ketoacidosis is if idiosyncratic diabetologist. At the time to foster other collaborations, notably discussed above. But George in later life clinical biochemistry had advanced to with Harry Keen and thus pumped in- highlighted other areas of diabetes man- allow glucose-specific assay in blood/ sulin therapy, glucose control and comp- agement with insulin as being of his great- plasma by glucose oxidase, intermediary lications, and the trio of the World est contributions (7), and it is difficult to metabolites by enzymatic dehydrogenase Health Organization (WHO), European disagree. 1156 Profiles in Progress Diabetes Care Volume 40, September 2017 Quite how the concept of continuous George immediately saw the potential Roy Taylor (insulin insensitivity), Loranne subcutaneous insulin infusion (CSII) was for “reversing” the glucose clamp in Agius (hepatocyte biochemistry), Sally generated between John Parsons, Harry order to compare animal and human in- Marshall (nephropathy), and Mark Walker Keen, and George Alberti, apparently in sulins in terms of potency and clearance (genetics).
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