A Brief History of Diabetes and Its Treatments
Millions of people around the world are affected by diabetes, a condition in which the blood sugar levels are higher than normal. People with diabetes are more likely to develop heart disease, and are also more likely to have certain risk factors such as high blood pressure or high cholesterol that increase the chances of having cardiac issues and stroke. Since its discovery, there have been massive improvements in the treatment of this condition.
History of Diabetes
The full name of the disease – diabetes mellitus – comes from the Greek word for passing through or siphoning (diabetes) and the Latin word for sweet or honey (mellitus). The term diabetes was first used in 250 BC by Apollonius of Memphis. The word first appears in medical texts dating back to 1425. The term mellitus was added in 1675 by Thomas Willis who noted that the urine of people with diabetes was sweet tasting. This was confirmed a century later by Matthew Dobson in 1776 who came to the conclusion that the sweet-tasting urine was on account of excess sugar. Interestingly, it was Dobson who recognized that the disease had two forms and that it was fatal in some patients and a chronic condition in others. This was the first time that a clear distinction between diabetes type 1 and type 2 was noted.
Discovery of Pancreas and Insulin
Oskar Minkowski and Joseph von Mering identified that the pancreas plays a role in diabetes. In 1889, they noted that dogs who had the pancreas removed displayed the signs and symptoms of diabetes and died a short time later. Sir Edward Sharpey-Schafer make a major breakthrough in 1910 when he identified that the pancreas produces a chemical and lack of this chemical leads to the development of diabetes. The chemical was named insulin after the Latin word for island (insula) because the pancreatic cells that produce insulin are called the islets of Langerhans.
Early Treatments for Diabetes
Greek physicians initially recommended horseback riding and other exercises to control the excess urination. They also tried to compensate fluid loss by encouraging patients to drink lots of wine. Needless to say, these treatments were ineffective and people with diabetes often suffered severe complications.
In the 1900s, a number of ineffective treatments were tried including oats, milk, rice, potatoes, opium, and drinking excessive amounts of fluids. Finally, in 1921, Charles Herbert Best and Sir Frederick Grant Banting showed that insulin was an effective treatment for diabetes. This was confirmed by the experiments of Banting and Best who found that injecting pancreatic extracts obtained from healthy dogs could reverse the disease in dogs with diabetes. Humans were treated with insulin when a purified form of the hormone was obtained from cows by John Macleod and James Collip.
A 14-year-old boy called Leonard Thompson received the first injection of insulin for diabetes in 1922 and lived for more than a decade after that. The same year, Eli-Lilly began mass producing insulin in the United States, prompting its widespread use worldwide to manage diabetes.
The first person to differentiate between type 1 and type 2 diabetes based on research was Sir Harold Percival Hemsworth in 1936. He introduced the concept of insulin resistance, which is now one of the known causative factors of type 2 diabetes. Type 2 diabetes is a result of insulin resistance in combination with impairment of function in the insulin-producing beta cells.
Further research into insulin led to the development of Humulin, a biosynthetic insulin that is structurally similar to human insulin. Mass production of Humulin was a watershed moment in the treatment of diabetes. Another major breakthrough was the introduction of Accu-Chek or Reflolux in 1983 as a method of monitoring blood sugar. Insulin pens appeared on the market in the mid-1980s and the mid-1990s saw the entry of instant tablets. Modern-day treatments include insulin analogs and newer methods of drug delivery.
In the 1990s, better treatments for diabetes were developed which had fewer side effects, better disease management, improved flexibility, and ease of management. At present, external insulin pumps and more than 300 insulin analogs are on the market offering a customized approach to every patient.
At present, there are several promising new treatments under development. Researchers at the University of Ottawa are studying the role of cathelicidin antimicrobial peptide CAMP, a protein that kills bacteria. This protein is present in the pancreas and may be linked to type 1 diabetes. Scientists believe it would be helpful in insulin production.
Several research projects funded by the American Diabetes Association (ADA) are trying to find answers to questions such as what triggers type 1 diabetes and whether there is a link between stress and type 2 diabetes. The journal Lancet reports ongoing research on a bionic pancreas, which would be a major breakthrough in understanding why the immune system in people with type 1 diabetes attacks the body’s own insulin-producing cells.
More than 25 million Americans and nearly 10 percent of the total population has diabetes. This is a treatable condition, but untreated can lead to a number of complications and health problems, which is why improvements in the treatment of diabetes and ways to prevent the disease continue to be important.