By Dr Ananya Mandal, MD
Origin of the term ‘diabetes’
The term diabetes is the shortened version of the full name diabetes mellitus. Diabetes mellitus is derived from the Greek word diabetes meaning siphon - to pass through and the Latin word mellitus meaning honeyed or sweet. This is because in diabetes excess sugar is found in blood as well as the urine. It was known in the 17th century as the “pissing evil”.
The term diabetes was probably coined by Apollonius of Memphis around 250 BC. Diabetes is first recorded in English, in the form diabete, in a medical text written around 1425. It was in 1675 that Thomas Willis added the word “'mellitus'” to the word diabetes. This was because of the sweet taste of the urine. This sweet taste had been noticed in urine by the ancient Greeks, Chinese, Egyptians, Indians, and Persians as is evident from their literature.
History of the treatment of diabetes
Sushruta, Arataeus, and Thomas Willis were the early pioneers of the treatment of diabetes. Greek physicians prescribed exercise - preferably on horseback to alleviate excess urination. Some other forms of therapy applied to diabetes include wine, overfeeding to compensate for loss of fluid weight, starvation diet, etc.
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.
In ancient times and medieval ages diabetes was usually a death sentence. Aretaeus did attempt to treat it but could not give a good outcome. Sushruta (6th century BCE) an Indian healer identified diabetes and classified it as “Madhumeha”. Here the word “madhu” means honey and combined the term means sweet urine. The ancient Indians tested for diabetes by looking at whether ants were attracted to a person's urine. The Korean, Chinese, and Japanese words for diabetes are based on the same ideographs which mean “sugar urine disease”.
In Persia Avicenna (980–1037) provided a detailed account on diabetes mellitus in “'The Canon of Medicine”. He described abnormal appetite and the decline of sexual functions along with sweet urine. He also identified diabetic gangrene. Avicenna was the first to describe diabetes insipidus very precisely. It was much later in the 18th and 19th century that Johann Peter Frank (1745–1821) differentiated between diabetes mellitus and diabetes insipidus.
Discovery of the role of the pancreas
Joseph von Mering and Oskar Minkowski in 1889 discovered the role of pancreas in diabetes. They found that dogs whose pancreas was removed developed all the signs and symptoms of diabetes and died shortly afterwards.
In 1910, Sir Edward Albert Sharpey-Schafer found that diabetes resulted from lack of insulin. He termed the chemical regulating blood sugar as insulin from the Latin “insula”, meaning island, in reference to the insulin-producing islets of Langerhans in the pancreas.
In 1919 Dr. Frederick Allen of the Rockefeller Institute in New York published his “Total Dietary Regulations in the Treatment of Diabetes” that introduced a therapy of strict dieting or starvation treatment – as a way to manage diabetes.
Discovery of insulin
In 1921 Sir Frederick Grant Banting and Charles Herbert Best repeated the work of Von Mering and Minkowski and went ahead to demonstrate that they could reverse induced diabetes in dogs by giving them an extract from the pancreatic islets of Langerhans of healthy dogs.
Banting, Best, and their chemist colleague Collip purified the hormone insulin from pancreases of cows at the University of Toronto. This led to the availability of an effective treatment for diabetes in 1922. For this, Banting and laboratory director MacLeod received the Nobel Prize in Physiology or Medicine in 1923; both shared their Prize money with others in the team who were not recognized, in particular Best and Collip.
Banting and Best made the patent available free of charge so that millions of diabetics worldwide could get access to insulin.
In 1922 January, Leonard Thompson, 14, a charity patient at the Toronto General Hospital, became the first person to receive and injection of insulin to treat diabetes. Thompson lived another 13 years before dying of pneumonia at age 27.
Differentiating type 1 and type 2 diabetes
It was in 1936 that Sir Harold Percival (Harry) Himsworth in his published work differentiated type 1 and 2 diabetes as different entities.
Biosynthetic human insulin
In 1982 the first biosynthetic human insulin – Humulin – that is identical in chemical structure to human insulin and can be mass produced was approved to market in several countries.
Metabolic syndrome, that diabetes mellitus forms a part of was discovered by Dr Gerald Reaven's in 1988. Banting was honored by World Diabetes Day which is held on his birthday, November 14 staring 2007.
Reviewed by April Cashin-Garbutt, BA Hons (Cantab)