The Story of Diabetes Mellitus

by Michael_Koger

Though they may not have understood its pathophysiology, scientists have long recognized the occurrence of diabetes mellitus.

Three thousand years ago, Egyptians observed a group of patients who were thirsty, hungry, and who urinated a great deal. There are also written descriptions in 1550 B.C. of individuals with clinical signs and symptoms of this disease. Moreover, ancient medical literature from India illustrates a similar condition which may have its onset at birth or several years into the lifetime [1].

Some physicians, in fact, wondered whether this illness had its origins in the human nervous system. It seemed to be some type of wasting disease, and they suggested that the sweet urine and blood in these clients were evidence of fat and sugar breakdown in the body. This, the researchers postulated, caused them to lose weight [1].

Clinical Observations of Disease

In the 11th century, an Arab physician, Avicenna, noted that these patients developed erectile dysfunction and peripheral neuropathy.  Their deep tendon reflexes were less than normal or absent, and their extremities were cold and livid.  They developed skin ulcers, and this, perhaps, was the result of vascular disease and gangrene.  Sensation in the feet of these clients was also diminished.  In the 19th century, doctors further confirmed these observations [1].

In 1675, Thomas Willis, a physician on the medical staff of Guy’s Hospital in London, United Kingdom, described the urine of these patients as “wonderfully sweet as if it was imbued with honey or sugar” [1].

Link between Diabetes Mellitus and the Pancreas

In 1673, Johann Brunner removed the pancreas of dogs, and he noticed that they had signs and symptoms which were similar to those of humans who had diabetes mellitus.  Though some scientists were reluctant to accept this idea, the research paved the way for more investigation which eventually identified a hormone in the pancreas that kept the blood sugar in humans and animals under satisfactory control [1].

Dogs that had undergone pancreatectomy quickly became seriously ill and died [1].

The story of Banting and Best, two researchers who obtained permission to use the laboratory of Professor John Mcleod at the University of Toronto in 1921, has been well-known to many medical students.  Best was previously one of Mcleod’s undergraduate students.  The two scientists wanted to establish a connection between internal secretion of a hormone from the pancreas and regulation of blood sugar [1].

Ultimately, the three researchers presented their findings to the American Physiological Society at Yale University, and Banting and Mcleod received the Nobel Prize in Medicine for their remarkable discovery [1].

During the 20th and 21st centuries, there have been developments in the use of insulin and oral agents to lower the blood sugar in diabetics.  Dietary management has also progressed with the use of calorie counting and meal arrangement of certain food types for these clients.  Laboratory assays to measure the serum glucose have dramatically improved, and individuals can test and monitor their blood sugar at home several times daily [1].

Conclusion

The road to discovery and comprehension of diabetes mellitus has been a long one, and pioneer scientists over the millennia deserve much credit for what they have observed.

References

  1. Ahmed, A.  (2002).  History of diabetes mellitus.  Saudi Medical Journal, 23, 373-378.
  2. The photo is of a library at the United States Centers for Disease Control.

Disclaimer

The information contained in this article is for educational purposes only and should not be used for diagnosis or to guide treatment without the opinion of a health professional. Any reader who is concerned about his or her health should contact their physician for advice.

Updated: 07/12/2015, Michael_Koger
 
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