Vuk Vrhovac and his role in the development of Croatian diabetology

Abstract

This paper analyses the professional and scientific articles of Vuk Vrhovac published in Liječnički vjesnik between 1935 and 1946, with the aim of evaluating his contribution to the development of diabetology and endocrinology in Croatia. Through content analysis of these works, the level of contemporaneous medical knowledge on diabetes mellitus is reconstructed, and Vrhovac’s role in the transfer and application of modern therapeutic and organisational models within the domestic healthcare system is examined. In his 1935 article, Vrhovac discussed then current clinical and physiological issues of diabetes, distinguishing between juvenile and adult forms of the disease and emphasising the complexity of the metabolic disorder, which affects not only carbohydrate metabolism but also lipid metabolism. He particularly highlighted the association between elevated serum lipids and the development of vascular complications at a time when the pathophysiology of atherosclerosis was not yet fully understood, demonstrating an awareness of the broader cardiovascular context of the disease. In his 1936 paper on non-diabetic melliturias, he analysed the differential diagnostic causes of glycosuria. In 1937, he published a series of articles on patients with concurrent diabetes and tuberculosis, emphasising the need for collaboration between internists and phthisiologists, as well as the adaptation of diet and therapy. In a 1942 paper, he examined the relationship between essential hypertension and diabetes, reflecting contemporary hypotheses on endocrine mechanisms of disease. His final paper, published in 1946, was devoted to long-acting insulins and their clinical application, including a detailed account of experiences with protamine zinc insulin developed in Zagreb. Vrhovac’s work testifies to his systematic monitoring of global medical advances and their rapid implementation into domestic medical practice. His role in organising insulin production, developing therapeutic protocols, and shaping professional thought justifies his place among the founders of Croatian diabetology and endocrinology. Despite a relatively short professional career, he established the fundamental organisational and professional frameworks upon which this discipline later developed in Croatia.