Diabetes History

An Egyptian papyrus mentions a rare disease that causes the patient to lose weight rapidly and urinate frequently. This is thought to be the first reference to diabetes.

The creation of the term “diabetes” is credited to Apollonius of Memphis, which refers to a disease which drains patients of more fluid than they can consume.

A Greek physician, Galen of Pergamum, theorises that diabetes is an affliction of the kidneys. After this period, diabetes is rarely mentioned.

A Persian polymath called Avicenna (980-1037) publishes “The Canon of Medicine” in 1025, providing a detailed account on diabetes mellitus. The sweet urine of people with diabetes is described, as is abnormal appetite, diabetic gangrene and sexual dysfunction.

Around this period, ‘uroscopy’ becomes a way of identifying disease, which involves examining the colour, sediment and odour of urine to try to establish what is wrong with the patient. Some physicians even taste the urine, and this is apparently how diabetes is given its second name mellitus, meaning ‘honey’ in Latin.

Matthew Dobson identifies that the sweet taste in the urine of people with diabetes is due to excess sugar in the urine and the blood. He also observes that diabetes is fatal for somen, leading to death within five weeks, while others live much longer. This is the first indication of two different types of diabetes: type 1 and type 2.

John Rollo treats a patient using a high-fat and protein diet, the first significant dietary approach to the treatment of diabetes.

Claude Bernard coins the term “glycogen” after discovering a substance formed by the liver that he reports is the same sugar found in the urine of those with diabetes. This is the first link between diabetes, glycogen and metabolism.

Johann Peter Frank is credited as being the first physician to distinguish clinical differences between diabetes mellitus and diabetes insipidus. ^[335]

By the early 19th Century, chemical tests have been devised which can detect excess sugar in the urine. Despite therapies being proposed, in the absence of a cause, they prove unsuccessful. It was not until the Franco-Prussian War, when the French Physician Bouchardat noticed that restricted diets helped his patients, that calorie intake is recognised as important.

Medical student Paul Langerhans reveals that the pancreas contains two types of cells, of which one secretes tiny cells islands. The function of these cells is currently unknown; they go on to be referred to as the “Islets of Langerhans”.

Joseph von Mering and Oskar Minkowski remove pancreases from dogs and discover that they develop the symptoms of diabetes.

Jean de Meyer and Sir Edward Albert Sharpey-Schafer both independently propose the name “insulin”, it is believed, in reference to the tiny cell islands in the pancreas – the islets of Langerhans. Insulin is latin for “insula”, meaning island.

Stanley Rossiter Benedict devises a new method to measure glucose in sugar, which comes to be known as Benedict’s Solution.

Dr Frederick Allen publishes a book, “Total Dietary Restriction in the Treatment of Diabetes”, which reveals case records of diabetes patients treated with the ‘starvation diet’. The treatment helps extend the lives of diabetes patients, but many of his patients die as a result of starvation.

It is not until 1920 that an American called Moses Barron links the Langerhans cells with the basis of diabetes mellitus. Picking up on the research of Barro, a doctor called Frederick Banting conducts critical experiments linking the pancreas and diabetes. Banting and Charles Best demonstrate that administering the islets of Langerhans from healthy dogs to dogs which have had their pancreases removed can treat high sugar levels.

James Collip purifies this insulin and it is treated for the first time on a huma, 14-year-old Leonard Thompson The work is considered a great success. The average life expectancy for a child with type 1 diabetes at the beginning of the 20th Century is roughly a year; Leonard lives until the age of 27, when he eventually dies of pnuemonia

Banting and JJR Macleod, who gave Banting and Best his laboratories to work i, are recognised for their achievement with a Nobel Prize in 1923. Banting shares his award with Best; Macleod shares his with Collip.

Eli Lilly strikes a deal for the first mass production of insulin in North America.

Sir Harold Percival publishes research which divides diabetes into type 1 and type 2 based on the degree of insulin sensitivity in patients.

Insulin treatments continue to develop and by 1945 the life expectancy of someone with diabetes is increasing. By 1945, a newly-diagnosed 10-year-old has a life expectancy of 45 years; a 50-year-old might live for another 16 years.

Dr Elliot Proctor Joslin and his staff develop the first hospital blood glucose monitoring system. Joslin also sets up The Victory Medal award in 1947 to celebrate patients who live with diabetes for 25 years and have no health complications regarding their kidneys, eyes and blood vessels.

Helen Free develops the Clinistix “dip-and-read” urine test which allows instant monitoring of blood glucose levels.

The first oral drug is developed, carbutamide, to help lower blood glucose levels. ^[336]

Urine strips are made available for home testing helping people with diabetes get faster readings.

Blood testing technology also makes advances. Miles Laboratories releases Dextrostix, testing strips which require a drop of blood for a minute. The blood is then washed off and an indication of blood sugar levels is revealed on a colour chart.

Doctors at the University of Minnesota attempt the first pancreas transplantation in an attempt to cure type 1 diabetes.

The first insulin pump is invented by Dean Kamen. Another insulin breakthrough is made in the form of U-100 insulin.

The HbA1c test is introduced into clinical laboratories for the first time in 1977.

The first synthetic human insulin is produced using recombinant DNA techniques. Prior to this development insulin manufacturers have had to stockpile pancreatic tissue from animals.

Humuli, the first biosynthetic human insulin, is approved for distribution in several countries. It is identical to the structure of human insulin and has the advantage of being less likely to lead to allergic reactions than animal insulin.

The first insulin pen delivery system, called the NovoPe, is introduced by Novo Nordisk in 1985.

The World Health Organisation launches World Diabetes Day in response to the rapid rise of diabetes around the world. It is held on November 14, the birthday of Frederick Banting.

Medtronic releases the MiniMed 506 insulin pump, which delivers meal bolus memory and daily insulin totals.

The landmark Diabetes Control and Complications Trial (DCCT) report is published, demonstrating that regular activity and good nutrition help to improve diabetes control and stave off the risk of long-term health complications.

Instant Glucose tablets are introduced, marking a significant development in treating hypoglycemia.

The first recombinant DNA human analogue insulin is marketed by Eli Lilly. Humalog (lispro) is genetically engineered insulin which contains an amino acid sequence and alters how insulin is absorbed.

Dr Richard Bernstein publishes ‘Diabetes Solution’ which addresses lowering carbohydrate intake as a means of achieving good blood glucose control and avoiding diabetes-related complications.

There is growing interest in islet cell transplantation as Shapiro et al publish findings from seven patients with type 1 diabetes who undergo the procedure as a means of helping them achieve insulin independence.

Suzanna M. de la Monte proposes the term “ type 3 diabetes ” to describe insulin resistance in the brain.

The University of Cambridge trials an artificial pancreas which combines the technology of an insulin pump with a continuous glucose monitor.

Dr Edward Damiano introduces the iLet , a bionic pancreas that delivers both insulin and glucagon every five minutes. Damiano describes the device as a “bridge to a cure”.