Diabetes Mellitus

How long has diabetes been known as a disease?

Written by StopDiabetes

Symptoms of diabetes (though it was not called diabetes) were known around 3,500 years ago and were first recorded by the Egyptians. By the mid-seventh century, the Chinese physician Chen Ch’üan (c. 640 C.E.) also noted the symptoms of diabetes, including excessive thirst and sweet urine. In the first century, the celebrated Greek physician Aretaeus of Cappadocia (81–138 C.E.) called it diabainein, from the Greek dia (“to pass through”) and bainein (“to go”), referring to the excessive urination associated with the disease. He further noted the horrible way in which the patients with the disease met their demise, writing that, as far as he could tell, it was the “melting down of the flesh and limbs into urine.” And around the early eleventh century, the Persian physician Avicenna (980–1037) supposedly described the disease and its many consequences.

Where does the term “diabetes” come from?

The term as “diabetes” was first mentioned in 1425 (as diabete), from the Latin. This, in turn, comes from the ancient Greek words dia meaning “to pass through” and betes meaning a “water tube,” thus the loose translation that is often seen as “water siphon.” The word mellitus was added probably around 1670 (see below), from the Latin for “like honey” or “sweetened with honey” to reflect the sweet smell (and taste) of the patient’s urine.

Who was Thomas Willis?

Thomas Willis (1621–1675) was an English physician who is most remembered for his rationalist approach to the human brain and nervous system. Although many historians consider his contributions to diabetes minor (others centuries before had noted the symptoms; see above), he did rediscover that urine from people with diabetes tasted sweet and is credited with referring to the condition as diabetes mellitus, or “honey diabetes,” around 1670.

(There is some disagreement as to this date, with some references suggesting that the scientific term diabetes mellitus was first used in 1860.) He is often called the “first modern Western physician” to rediscover the sweet urine–diabetes connection. But instead of sugar, he attributed the sweetness of urine to salts and acids. He also thought this disease was a rare condition before his time and believed diabetes in his time was from excessive living. He also associated the disease with depression, stating that “diabetes is caused by melancholy.”

How did early doctors “test” for diabetes in patients?

Around 1670, Thomas Willis announced the rediscovery of the connection between diabetes and the sweetness of the patient’s urine, although the symptoms of the disease had already been noted earlier by the Egyptians, Chinese, Greeks, and Indians. Doctors who knew about the disease—it had yet to be understood—would then diagnose the disease by tasting a patient’s urine. This is because when the blood glucose levels in a person rise, the body takes out water from the cells’ tissues and eliminates the sugar through the urine. As time went on, not all doctors used the modern tests, often discovering the disease in a patient through tasting the urine. It was even, as some reports mentioned, noticed by observation. For example, one report stated that in the 1800s, an incontinent person with diabetes and on his or her deathbed would often attract black ants.

Who was Matthew Dobson?

English physician and experimental physiologist Matthew Dobson (1732–1784) was the first to discover, in 1775, that sugar was the sweet substance in the patients with diabetes (caused by hyperglycemia). His work, Experiments and Observations on the Urine in Diabetics (1776), did not have a great impact on the medical community. He also noted that diabetes was not associated with the kidneys, as many physicians believed at that time.

What is polyuria?

Polyuria is when a patient urinates excessively, usually producing dilute urine. This excessive urination is often one of the first symptoms of uncontrolled diabetes, especially of type 1 and type 2 diabetes, in both children and adults. This symptom was known by many early physicians before the main reasons for diabetes were understood.

Who was Michel Chevreul?

In 1815, Michel Eugène Chevreul (1786–1889), a French chemist, showed that the sugar or sweetness in the urine of a person with diabetes came from what he termed “grape sugar.” It is what is now known as glucose. In Chevreul’s time, the finding was an important step toward understanding diabetes.

What did early doctors think caused diabetes?

Diabetes was not well understood until the early 1900s. Before then, there were many suggestions as to the cause. For example, many doctors believed the disease was just an imbalance in the body. They believed the reason for a patient’s experiencing excessive urination, profuse sweating, and often vomiting was that the body was trying to get back into balance again.

What were some early common treatments for patients with diabetes?

Because diabetes was so misunderstood, there were many treatments that seem bizarre and even dangerous by today’s standards. One of the most popular treatments was commonly used for almost all diseases in the 1800s—the practice of bleeding the patient. Others included having the person fast (many times to near starvation), having him or her eat excessive amounts of sugar, giving the person only the meat and fat of animals to eat, or feeding him or her specific herbs that were thought to cleanse the body of diabetes.

Who were Jean De Meyer and Edward Sharpey-Schäfer?

English physiologist Edward Albert Sharpey-Schäfer (1850–1935) was the first scientist to suggest that the pancreas was connected to blood sugar levels in the body. He was also the first person to discover adrenaline and inferred the existence of “insuline,” the term he used for what is now called insulin. Several years before, Belgian clinician and physiologist Jean-Egide-Camille-Philippe-Hubert De Meyer (1878–1934) worked on pancreatic secretions and also suggested the name “insuline”—the original French—13 years before the hormone was isolated. Sharpey-Schäfer was apparently unaware of De Meyer’s work.

As early as 1895, Sharpey-Schäfer theorized that glucose came from the pancreas and originated in the islets of Langerhans. He also suggested several ideas about the nature of insuline, including that it may be an enzyme that the body uses to metabolize glucose. The theory he preferred was that insuline may inhibit the breakdown of glycogen, and if the liver did not have this “inhibitor,” it would no longer store glucose, causing it to spill into the body’s circulation.

Who discovered the connection between the islets of Langerhans and diabetes?

American physician and pathologist Eugene Lindsay Opie (1873–1971) was the first to discover the relationship between the islets of Langerhans (found in the pancreas) and diabetes. After examining postmortem patients who had developed diabetes, he correctly assumed that degenerative changes in the tissues of the pancreas (or islets of Langerhans) caused the diabetes. Along with his diabetes-and-pancreas discoveries, Opie was also known for his research on the causes, transmission, and diagnosis of tuberculosis (TB) and worked on immunization against the disease. He was also the first to suggest that an obstruction at the junction of the bile and pancreatic ducts was responsible for acute pancreatitis.

Which researchers are credited with discovering insulin?

The credit for the discovery of insulin most often goes to Canadian physician Frederick Grant Banting (1891–1941), Scottish biochemist and physiologist John James R. Macleod (1876–1935), and Canadian medical scientist Charles Best (1899–1978). Although earlier researchers had suggested that the pancreas secreted a substance that controlled the metabolism of the body’s blood sugar, it was not proven until 1922, when Banting, Macleod, and Best announced their discovery. In 1921, they had begun experimenting on dogs, removing the animals’ pancreases, essentially making the dogs diabetic. They would then grind down the animals’ organs and extract a solution they called isletin. Injecting the solution into other animals resulted in a drop in blood sugar levels. By January 1922, they formulated an extract—this time from cattle pancreases—to try on humans with type 1 diabetes (see Leonard Thompson, below). When Thompson had an allergic reaction, Canadian biochemist James Bertram Collip (1892–1965) worked for about 11 straight days, making the injection more “pure” for humans. The new solution worked, and after several more patients were treated successfully, insulin eventually became one of the best treatments for people with diabetes.

 

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