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Obituary: David Robert Hadden

David Robert Hadden Professor David Hadden was an internationally recognised expert on growth, nutrition and diabetes. Anticipating the impact of the westernised lifestyle on the epidemic of type 2 diabetes, in 1972 he set up the Belfast Diet Study, which confirmed that strict adherence to diet alters the natural history of the disease. Subsequently his collaboration in the UK Prospective Diabetes Study demonstrated for the first time the importance of good control of blood glucose in preventing complications of type 2 diabetes.

His other great contribution was in the management of diabetic pregnancy. The joint diabetes obstetric service he built up was an example copied nationally. He led the involvement of Belfast as major centre and main laboratory in the Hyperglycaemia and Adverse Pregnancy Outcome Study, which highlighted the potentially harmful effects of small increases in blood sugar on the non-diabetic mother – findings that continue to challenge and change practice.

David Hadden came from a well known Irish medical family. His great grandfather was a doctor in Skibbereen, Co Cork, where he treated victims of the Irish potato famine. His grandfather became ship’s doctor on an ocean liner bound for Liverpool from New York. The chance event of the ship running aground on the North Antrim coast led to him settling in Northern Ireland and setting up practice in Portadown, where his grandson was born. David Hadden grew up across the road from the practice run by his grandfather, father and aunt. After primary school in the war years, he attended Campbell College, and then medical school at Queen’s University, Belfast. Fellow students remember a tendency to be late for lectures often finishing breakfast at the back of the hall, wearing a deerstalker hat in cold weather. Despite this he graduated with honours in 1959, winning the Thomson Medal for top marks in the final examination in medicine.

His training through the early 1960s, in his chosen specialty of endocrinology and diabetes, began in the Royal Victoria Hospital, Belfast. After a Clinical Research Fellowship using the new technique of radioimmunoassay to measure growth hormone, he travelled as Fulbright Fellow to the Johns Hopkins Hospital, Baltimore, USA . His report in the journal Nature of a growth hormone binding protein, although dismissed by conventional thinking at the time, is now recognised as one of the first descriptions of that important regulatory protein. He brought this interest back to Belfast, as the first children with short stature and growth hormone deficiency were treated using growth hormone extracted from human pituitary glands. His own children also remember being lined up in his study each year to have height and weight measured and plotted on a centile growth chart, a tradition later extended to his seven grandchildren.

Continuing his interest in growth and nutrition as MRC Fellow at the Infantile Malnutrition Research Unit in Kampala, Uganda, and then the Department of Experimental Medicine in Cambridge, he was asked to explore the cause of hypoglycaemia in babies with kwashiorkor. He was able to show that these children were in fact insulin resistant, with abnormally high blood glucose and insulin levels, differing from the more striking cases of total starvation (marasmus). This experience in malnutrition was also carried back to Belfast as he developed his ideas on the treatment of Type 2 diabetes, at least in part a disease of excessive nutrition.

Returning to the Metabolic Unit at the Royal Victoria Hospital as Consultant Physician in 1967, he worked there until his retirement in 2001. He was an extraordinarily caring physician, who regarded himself as permanently on-call. The pressure experienced by colleagues from his attention to detail and determination to get things right was balanced by his friendly manner as well as clear personal commitment and example. His clinical work and research covered the full range of endocrinology and diabetes and extended well past formal retirement.

His work and qualities were marked by an Honorary Chair at Queen’s University Belfast and by lectureships including the 1998 Jorgen Pedersen Lecture of the Diabetes Pregnancy Study Group of the European Association for the Study of Diabetes, the 2006 Norbert Freinkel Lecture of the American Diabetes Association and, in 2012, the first Lifetime Achievement Award of the Irish Endocrine Society. These recognised scientific excellence in the true sense of knowing and sharing work with colleagues.

Locally he is remembered by generations of Belfast medical students who, for over 25 years, attended his Saturday morning case demonstrations in endocrinology and diabetes. Ever approachable, open to new ideas and encouraging, this commitment summed up his desire to help and support colleagues.

Of many interests outside medicine, the most memorable was the project to produce Irish linen, possibly inspired by his mother’s family, who had been involved in the linen industry in its heyday. Starting with growing flax in a field at their country cottage in Co Down, he and his wife Diana succeeded, with some difficulty, in arranging for the whole process including retting, spinning and weaving to be done in Northern Ireland. As foreign competition had undermined this once thriving industry, authentic Irish linen had not been manufactured locally for many years.

He is survived by his wife Diana, an accident and emergency doctor and artist, son Robert, neurologist, and daughters Katharine and Emily, engineer and landscape architect respectively.

Professor David Robert Hadden
born May 24th 1936, died February 26th 2014

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Obituary: David Robert Hadden