History of Diabetes

Physicians have observed the effects of Diabetes for thousands of years. For much of this time, little was known about this fatal disease that caused wasting away of the body, extreme thirst, and frequent urination. It wasn't until 1922 that the first patient was successfully treated with insulin.

One of the effects of Diabetes is the presence of glucose in the urine (glucosuria). Ancient Hindu writings, many thousands of years old, document how black ants and flies were attracted to the urine of diabetics. The Indian physician Sushruta in 400 B.C. described the sweet taste of urine from affected individuals, and for many centuries to come, the sweet taste of urine was key to diagnosis.

Around 250 B.C., the name "Diabetes" was first used. It is a Greek word that means "to syphon", reflecting how diabetes seemed to rapidly drain fluid from the affected individual. The Greek physician Aretaeus noted that as affected individuals wasted away, they passed increasing amounts of urine as if there was "liquefaction of flesh and bones into urine". The complete term "diabetes mellitus" was coined in 1674 by Thomas Willis, personal physician to King Charles II. Mellitus is Latin for honey, which is how Willis described the urine of diabetics ("as if imbued with honey and sugar").

Up until the mid-1800s, the treatments offered for Diabetes varied tremendously. Various "fad" diets were prescribed, and the use of opium was suggested, as were bleeding and other therapies. The most successful treatments were starvation diets in which calorie intake was severely restricted. Naturally, this was intolerable for the patient and at best extended life expectancy for a few years.

A breakthrough in the puzzle of diabetes came in 1889. German physicians Joseph von Mering and Oskar Minkowski surgically removed the pancreas from dogs. The dogs immediately developed diabetes. Now that a link was established between the pancreas gland and diabetes, research focused on isolating the pancreatic extract that could treat diabetes.

When Dr. Frederick Banting took up the challenge of isolating a pancreatic extract, he was met with much skepticism. Many great physiologists had tried and failed to isolate an internal secretion from the pancreas. But Banting, a surgeon, persisted and in May 1921, he began work in the laboratory of Professor John Macloed in Toronto, Canada. Charles Best, a medical student at the time, worked as his assistant.

To concentrate what we now know as insulin, Banting tied the pancreatic ducts of dogs. The pancreatic cells that released digestive enzymes (and could also destroy insulin) degenerated, but the cells that secreted insulin were spared. Over several weeks the pancreas degenerated into a residue from which insulin could be extracted. In July 1921, a dog that had had its pancreas surgically removed was injected with an extract collected from a duct-tied dog. In the two hours that followed the injection, the blood sugar level of the dog fell, and its condition improved. Another de-pancreatized (diabetic-like) dog was kept alive for eight days by regular injections until supplies of the extract, at that time called "isletin", were exhausted.