But for centuries, this increasing precision in disease recognition was not followed by any effective treatment -- more details didn't make physicians any less helpless. At the time, they were unknowingly confusing two kinds of diabetes: Type 1, known until recently as ''juvenile diabetes,'' which is more extreme but less common than Type 2, or ''adult onset,'' which seems to be related to obesity and overeating. With Type 1 (what Elizabeth Hughes had), the pancreas stops secreting insulin, a hormone that instructs the body to use the sugar in the blood for energy. With Type 2, the pancreas produces insulin (at least initially), but the tissues of the body stop responding appropriately. By 1776, doctors were still just boiling the urine of diabetics to conclusively determine that they were passing sugar, only to watch their patients fall into hyperglycemic comas and die.