Diabetes is a metabolic disorder that affects the control of blood glucose. The American Diabetes Association reports that the number of people who suffer from diabetes continues to grow each year. (1) Today, five percent of the world’s population has it. Are there really more people developing the disorder or more people diagnosed? The question is difficult to answer.
Type 2 diabetes is a lifestyle illness that is often brought on by environmental factors that trigger genetic predispositions. Nutrition, environment and genetics all play a role in the development and treatment of the disease. But diabetes is not a disease of just the 20th century. In fact, written history exists as far back as 1552 B.C. when physician Hesy-ra, an Egyptian, first wrote about polyuria as a symptom.
This history dates back to centuries before Christ and continues to play a role today. In the early days doctors did not have sophisticated methods of testing people so they employed the help of people called ‘water tasters’. Up through the 11th century these people would taste the urine of those suspected to have diabetes, or sugar in their urine, to see if there was a sweet taste to it. When the blood sugar increased sugar spilled out of the blood and into the urine. As a result the word ‘mellitus’ was added to the diagnosis (Latin word for honey, referring to the sweet taste of the urine). (2)
It was the early 19th century before scientists were able to develop the first chemical tests that would indicate if there was glucose in the urine, eliminating the need for ‘tasters’. This was an important breakthrough in the diagnosis and treatment of diabetes. Now doctors could more consistently diagnose and monitor a condition that causes long-term health effects for the sufferer.
Treatment at this time wasn’t focused on diet until the 1870′s when French physician Bouchardat noticed that the gycosuria (sugar in the urine) was more common in his diabetic patients and decreased significantly during food rationing. The French were forced to ration their food during a siege by Germany during the Franco-Prussian war. After discerning this difference Bouchardat theorized that it was the diet that played an important role in treatment. (3)
Following the end of the war another French researcher, Claude Bernard, studied the function of the pancreas and liver. He made important discoveries in the metabolism of glycogen. At the same time in history Czech researcher, Pavlov, discovered the link between the nervous system and secretion of gastric acid. The combination of these discoveries later helped researchers to understand the physiology of the digestive system, ultimately important in the treatment of diabetes.
In 1869 Paul Langerhans, a German medical student, announced the discovery of two systems of cells in the pancreas. One of these cells, Cells of Langerhans, was named after him. But it wasn’t until 1920 that Dr. Banting conceived of the possibility of the hormone insulin and began a quest to discover the chemical using dogs. (4)
It was 20 years later that the link between high blood glucose and damage to the kidneys and eyes was discovered and published. This led the way for more standardized insulin treatment using a standard syringe. Then in 1959 physicians recognized the difference between Type 1 and Type 2 diabetes. This recognition helped to individualize the treatment of diabetics and lengthen their lifespan. This helped to decrease the risk for the development of complications. (5)
With the advent of laser surgery in 1970, researchers learned how to slow the development of progressive damage to the eyes. Other researchers began to manufacture glucometers to make testing of blood glucose more accessible and easier.
Synthetic insulin was introduced in 1983. Until that time standard insulin was supplied from cows or bovine insulin. Today synthetic insulin can be delivered through insulin pumps to significantly cut down on the number of complications that an individual suffers later in life. By delivering insulin in doses more in line with how the pancreas would deliver it to the body the individual doesn’t have the highs and lows they once experienced.
Because using an insulin pump reduces the number of complications, insurance companies recognize they are saving money in the long run. This has led them to decide to cover the cost of an insulin pump at earlier ages. Research is currently being conducted on the transplantation of pancreatic cells, without using immune suppressants, which will supply an individual with Type 1 diabetes with a natural source of insulin.
The diagnosis, treatment and complications of diabetes has come a long way from when ‘tasters’ were employed to diagnose diabetes through tasting sweet urine!
References
(1) American Diabetes Associations: Diabetes Basics Statistics
http://www.diabetes.org/diabetes-basics/diabetes-statistics/
(2) Saudi Medical Journal: History of Diabetes Mellitus
http://www.ncbi.nlm.nih.gov/pubmed/11953758
(3) Google Books: Transplantation of the Pancreas
By Rainer W. G. Gruessner, David E. R. Sutherland
http://books.google.com/books?id=2-lo9GE3aUEC&pg=PA41&lpg=PA41&dq=French+physician+Bouchardat+discovers+diabetes&source=bl&ots=QjRYsYgr7x&sig=RFU3v9lBynRyC9XjCJkZjqJWX5k&hl=en&sa=X&ei=EdISUL_JJ8KS0QG20ICQCg&ved=0CEMQ6AEwAjgK#v=onepage&q=French%20physician%20Bouchardat%20discovers%20diabetes&f=false
(4) Nobelprize.org: The Discovery of Insulin
http://www.nobelprize.org/educational/medicine/insulin/discovery-insulin.html
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