Guest Post: The History of Diabetes

Diabetes is the most common chronic health condition that affects the human population worldwide. In normal human bodies, the food we eat is broken down into glucose and released into the bloodstream. A spike in blood sugar signals your pancreas to release insulin. Insulin is a hormone that allows your body to use this glucose or sugar for the generation of energy.

When a person has diabetes, their body is either unable to produce sufficient insulin or is unable to utilize the insulin produced as well as it should. When there is an imbalance of insulin in the body, the blood sugar stays in your bloodstream causing serious health problems over time.

While a cure for diabetes has not yet been developed, there has been great progress made in this area and diabetes information is commonly available. Great strides have also been made in medicine on managing the impact of diabetes on your everyday life.

Origin of the term ‘diabetes’

The common term Diabetes is a derivative of the full name diabetes mellitus. Diabetes is a Greek word that means to siphon or pass through. Mellitus is a Latin word that means sweet or honeyed. The blood and urine of diabetes patients usually has excess sugar in it. In the 17^th century, since blood tests were not as common, patients with diabetes were said to be suffering from the “pissing evil”.

Earliest records of Diabetes

The first mentions of the term can be found as early as 250 BC. Apollonius of Memphis is commonly credited to have coined the term. In English language, the first records of diabetes are found in a medical text circa 1425, written in the form “diabete”. Thomas Willis attached the word “’mellitus’” to diabetes in 1675 after observing the sweetness of the urine of such patients. This sweet taste of urine had also been recorded in medical literature of the ancient Greeks, Egyptians, Chinese, Persians, and Indians.

History of Diabetes Treatments

The earliest pioneers of the treatment of diabetes are commonly thought to be Arataeus, Sushruta, and Thomas Willis. However, there are many records in history that detail the different types of treatments and therapy applied to diabetes over the ages

• Ancient Greek physicians recommended that the patient exercise on horseback to assuage excess urination. Other treatments included wine, starvation diet, overfeeding to compensate for loss of fluid weight, etc. Aretaeus attempted to find treatment for this condition but to no avail.
• In the medieval ages, diabetes management was impossible. Any one with diabetes was considered as good as dead. diabetes was usually a death sentence.
• In the 6th century BC, an Indian healer called Sushruta, managed to identify the condition and named it “Madhumeha”. This is a hindi word where “madhu” means honey and “meha” means water. Combined the term means sweet urine. In those days the patient was tested for diabetes by observing whether ants were attracted their urine.
• Evidence in ancient Korean, Chinese, and Japanese writings also use similar terminology, as diabetes is often called some variant of the “sugar urine disease”.
• In 980–1037, Persian scientist Avicenna wrote a thorough explanation on diabetes mellitus in his book “The Canon of Medicine”. He identified many symptoms of diabetes including abnormal appetite, diminished sexual function, as well as sweet urine. He was also the first person to identify diabetic gangrene. Avicenna was also the first one to identify and give an accurate account of diabetes insipidus in detail.
• In 1776 Matthew Dobson confirmed that the sweet taste of urine of diabetics was due to excess of a kind of sugar in the urine and blood of people with diabetes.
• Western doctors caught up to Avicenna much later when, Johann Peter Frank (1745–1821) wrote about the difference between diabetes mellitus and diabetes insipidus.

Discovery of the role of the pancreas in diabetes

In 1889, Joseph von Mering and Oskar Minkowski discovered the role played by the pancreas in development of diabetes. They were experimenting with dogs and discovered that the subjects where the pancreas had been removed rapidly developed signs and symptoms of diabetes, and could not sustain for much longer afterwards.

Later in 1910, Sir Edward Albert Sharpey-Schafer built on the research or Mering and Minkowski and isolated the fact that diabetes was caused by the absence of a hormone produced by the pancreas. Sir Edward Albert Sharpey-Schafer named the hormone insulin from the Latin word “insula”, which means island. He was referring to the islets of Langerhans found in the pancreas that produce insulin.

Starvation treatment of Diabetes

Dr. Frederick Allen of the Rockefeller Institute in New York published his paper on the “Total Dietary Regulations in the Treatment of Diabetes” in 1919. He recommended that a strict regime of extreme dieting and starvation was the only way to manage or “treat” the condition of diabetes.

The isolation of insulin and its use for diabetes treatment

In 1921 Sir Frederick Grant Banting and Charles Herbert Best further built upon the research of Von Mering and Minkowski. Their research attempted to prove that diabetes could be reversed. They injected an extract from the pancreatic islets of Langerhans of healthy dogs into dogs who had clinically induced diabetes in dogs. Later, Banting, Best, and Collip isolated the hormone insulin from cow pancreas at the University of Toronto. This eventually led to discovery of an effective diabeted treatment in 1922. For this groundbreaking discovery, Banting and laboratory director MacLeod received the Nobel Prize in Physiology or Medicine in 1923. They chose to share their Prize money with the other unrecognized members of their team, like Best and Collip. They also chose to make the patent of this available to everyone for free, in order to let the millions of diabetics get affordable access to the treatment.

The first patient to receive Insulin

Leonard Thompson, aged 14, became the first patient ever to get injected with insulin to treat diabetes in January 1922. He was a charity patient at Toronto General Hospital in Canada. He lived for 13 years after this, but eventually died at the age of 27 because of pneumonia.

The first Biosynthetic human insulin

Humulin, the first biosynthetic human insulin was approved to be marketed in several countries in 1982. Humulin is identical to human insulin in terms of chemical structure and is easily mass produced. This became the basis of all modern diabetes treatments and medications used today.

References:

http://www.ncbi.nlm.nih.gov/pubmed/11953758

http://www.diabetes.ca/diabetes-and-you/what/history/

http://www.japi.org/special_issue_april_2011/01_Diabetic_History.pdf

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