Misread and mistaken: Étienne Lancereaux’s enduring legacy in the classification of diabetes mellitus
Bibliographic record
Abstract
Historians of diabetes have long claimed that physicians were aware of two distinct types of diabetes mellitus by the 1880s, and that these were the direct forerunners of type 1, juvenile-onset and type 2, adult-onset diabetes. French physician Étienne Lancereaux (1829–1910), based on autopsy and clinical studies, classified diabetes either as diabète maigre (thin, or more accurately emaciated, diabetes), which he believed to be pancreatic in origin with a poor prognosis, or diabète gras (fat diabetes), which he believed had a much better prognosis and was not pancreatic in origin. Historians citing Lancereaux have claimed that he observed the former to occur in young and the latter in middle-aged and elderly people. We review the papers of Lancereaux to clarify his clinical observations and understanding of diabetes. Lancereaux’s description of diabète maigre bores little resemblance to juvenile diabetes and all of his thin patients were middle-aged or older. On the other hand, his diabète gras is akin to type 2 diabetes and he might well deserve credit for its characterization.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.010 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.001 |
| Bibliometrics | 0.004 | 0.004 |
| Science and technology studies | 0.001 | 0.003 |
| Scholarly communication | 0.003 | 0.006 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.003 | 0.008 |
| Insufficient payload (model declined to judge) | 0.002 | 0.003 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".