If there were a list of the scientific developments over the last half century that have improved the lives of people with diabetes, one of its striking features would be the number of milestones that involved Professor Harry Keen.
Born in 1925, Keen qualified at St Mary’s Hospital Medical School, London, on 5 July 1948, the same day that the NHS was established; it marked the start of his lifelong love of the NHS. After service in the Royal Army Medical Corps, he worked in the Professional Medical Unit at St Mary’s until 1953, when he became senior clinical assistant at the Diabetic Department at King’s College Hospital.
There, he worked under RD Lawrence, the legendary doctor who 19 years earlier had co-founded the British Diabetic Association (today called Diabetes UK) with H G Wells. After seven years at King’s, he undertook an international post-doctoral research fellowship at the National Institute for Health in the United States, which he completed in 1961, and then joined Guy’s Hospital in London as a senior lecturer. It was to be the start of an association with the hospital that would last for the rest of his life – and that would establish his reputation as one of the leading diabetes researchers of the 20th century.
What really made his mark was the Bedford Survey, a project he led in 1962 to try to discover how many people in Bedford had undiagnosed type 2 diabetes. His team recruited the Girl Guides, Boy Scouts, Women’s Institute and the Round Table to distribute pots to every home in the town and asked every adult to fill a pot with urine. Remarkably, almost 70 per cent of them did, leading not only to the identification of 250 people with undiagnosed type 2 diabetes, but to the first definition of the pre-diabetic state, which he termed “borderline diabetes”. The study was also the first to identify, at a population level, the relationship between glucose intolerance and risk of cardiovascular disease.
Two years later, Keen led the team that first identified the significance of very small amounts of a protein called albumin in the urine as a predictor of kidney failure, which is a common complication of diabetes. He and colleagues also developed a way of using antibodies to screen for and monitor these small amounts of albumin – and hence get an early identification of those people with diabetes who were at high risk of kidney disease. This work opened the way for the kidney screening that is today given to everyone with diabetes and which has prevented or delayed the need for dialysis for many people.
Following this work, in 1971 Keen was appointed Professor of Human Metabolism at Guy’s, where he headed the Academic Unit for Metabolic Medicine until his retirement in 1990. Perhaps the highlight of his professorship was the leading role he played in a landmark 1978 study that showed, again for the first time, that an insulin pump – where insulin is administered just beneath the skin – was technically feasible, could be tolerated by people with diabetes and could improve their blood glucose control. This study opened the way for more research into this technology and today there are thousands of people with type 1 diabetes in the UK who use a pump to help manage their condition.
As well as his scientific research, Keen was also active in healthcare policy. He helped to pioneer diabetes centres, where teams of experienced diabetes professionals become focal points for diabetes care and help to drive up standards. He was also a central figure in the preparation of the St Vincent Declaration of 1989, which was a document in which European governments and patients groups acknowledged the seriousness and scale of the challenge of diabetes – and which is now widely seen as a landmark in the history of governmental efforts to bring the condition under control.
He was also a passionate advocate of the NHS, leading a High Court challenge against Health Secretary Kenneth Clarke for spending millions of pounds on preparations for an internal market before the relevant legislation had become law and, as president of the NHS Support Federation, was until very recently an active member of the campaign against recent NHS changes. He even appeared in the new Ken Loach documentary, The Spirit of ’45.
Keen retired in 1990, becoming Professor Emeritus at Guy’s and, the following year, honorary president of the International Diabetes Federation. In 1998 he was awarded a CBE and became the first recipient of the United Nations/UNESCO Hellmut Mehnert Award for the Prevention of Diabetes and its Complications. His positions included Chair of the British Diabetic Association between 1990 and 1996, an organisation that, under its current name of Diabetes UK, he was vice-president of for the rest of his life.
Sir George Alberti, who worked with and knew Keen for 40 years, remembers him as a “truly remarkable individual”. “His contribution to world diabetes was enormous and his activities touched and improved the lives of countless people with diabetes world-wide,” said Alberti. Barbara Young, chief executive of Diabetes UK, said: “Harry was a fine clinician and researcher, a stalwart supporter and inspiration to us all at Diabetes UK and one of the great defenders of a first-class NHS open to all on equal terms.” His colleague Professor Giancarlo Viberti remembered him as “a generous and compassionate man – one of the most inclusive, non-discriminatory people I have ever met, a real force for scientific and social progress.”
Keen’s companion for 60 years was his wife, Anna, known as “Nan”, who was the sister of the left-wing intellectual Ralph Miliband. Through marriage he was uncle to Ed and David Miliband and, according to David, his marriage to Nan was a “remarkable partnership”. He remembered his “Uncle Harry” as a “remarkable, kindly, intelligent, caring, lovely man” who stood out in a political family for his knowledge of science. “Harry was an extraordinary man,” added Ed. “He was compassionate, engaged, deeply concerned about making our country a better place, with a passionate commitment to the NHS. We will all miss him profoundly.”
Professor Harry Keen, champion of people with diabetes worldwide: born London 3 September 1925; married 1953 Anna (“Nan”); one son, one daughter); died Watford 5 April 2013.