John E. Gerich: Father of Modern Physiology of Glucose Homeostasis, Counterregulation to Hypoglycemia, and Mechanistic Treatment of Diabetes.

Abstract

John “Jack” E. Gerich as a young child (left panel); at graduation from medical school, age 26 (middle panel); and at present (right panel). Original graph, hand drawn by John and completed by his wife, is a classic teaching example of the insulin dose-response curve. Printed with permission of the American Journal of Physiology (6). Top: Jack writing papers with one of his fellows (author Geremia Bolli) at the Mayo Clinic. Bottom: Jack and the author playing a game of pool in Jack’s basement. Jack, fishing on Beaver Lake (Pennsylvania). When the letter from Diabetes Care arrived inviting me to write a Profile in Progress on John Edward Gerich (Jack, to his friends), I assumed it was because of my long-term research association and friendship with him. I felt, in a way, like a dwarf asked to report on a giant standing in front of me. After initial hesitation, I decided to accept this challenging task to acquaint younger professionals who do not know Jack Gerich with what kind of scientist—and also what kind of man—he is. To ensure that my narrative did not miss any aspect of his extraordinarily large and multifaceted research, I consulted with several of his former fellows who had been associated with him and contributed so much to the golden era of clinical research in metabolism over the last few decades. My interest in Jack’s work started in 1979 when I came across his legendary paper in the Journal of Clinical Investigation on the relative roles of glucagon, catecholamines, and growth hormone responses in glucose counterregulation to acute, insulin-induced hypoglycemia (1). At that time, in my small laboratory in Perugia, Italy, I was able to measure plasma glucagon, catecholamines, and other counterregulatory hormones during hypoglycemia experiments in humans, but I had no idea how …