ASHORT HISTORY OF DIABETES





THE DISEASE OF diabetes mellitus (DM) has been recognized for thousands of years. The
ancient Egyptian medical text, Ebers Papyrus, written around 1550 BC, first described this
condition of “passing too much urine.”
 Around the same time, ancient Hindu writings
discussed the disease of madhumeha, which loosely translated means “honey urine.”

Afflicted patients, often children, were mysteriously, inexorably losing weight. Attempts to
stop the wasting were unsuccessful despite continual feeding, and the disease was almost
uniformly fatal. Curiously, ants were attracted to the urine, which was inexplicably sweet.
By 250 BC, the Greek physician Apollonius of Memphis had termed the condition
diabetes, which by itself connotes only excessive urination.

Thomas Willis added the term
mellitus, meaning “from honey” in 1675. This descriptor distinguishes diabetes mellitus from
a different, uncommon disease known as diabetes insipidus. Most commonly caused by
traumatic brain injury, diabetes insipidus is also characterized by excessive urination, but the
urine is not sweet. Fittingly, insipidus means “bland.”

Colloquially, the non-specific term diabetes refers to diabetes mellitus since it is far, far
more common than diabetes insipidus. In this book, the term diabetes only refers to
diabetes mellitus, and there will be no further discussion of diabetes insipidus.

In the first century AD, the Greek physician Aretaeus of Cappadocia wrote the classic
description of type 1 diabetes as a “melting down of flesh and limbs into urine.” This
summary captures the essential feature of this disease in its untreated form: excessive
urine production is accompanied by almost complete wasting away of all tissues. Patients
cannot gain weight no matter what they eat. Aretaeus further commented that “life (with
diabetes) is short, disgusting a
Tasting the urine of the stricken patient for sweetness was the classic diagnostic test for
diabetes (ewww. . .).

In 1776, the English physician Matthew Dobson (1732–1784)
identified sugar as the substance causing this characteristic sweet taste. The sweetness
was found not only in the urine, but also in the blood. Slowly, an understanding of diabetes
was unfolding, but a solution was still out of reach.


In 1797, the Scottish military surgeon John Rollo became the first physician to formulate
a treatment that carried any reasonable expectation of success. He had observed
substantial improvement in a diabetic patient eating an all-meat diet. Given the uniformly
grim prognosis of diabetes, this approach was a breakthrough. This extremely low
carbohydrate diet was the first diabetic treatment of its kind.

By contrast, French physician Pierre Piorry (1794–1879) advised diabetics to eat large
quantities of sugar to replace what they lost in their urine. While the logic seemed
reasonable at the time, it was not a successful strategy. A diabetic colleague unfortunate
enough to follow this advice later died, and history now only laughs at the good Dr. Piorry.

However, this outcome foretold the grim shades of our own highly ineffective advice to
follow a high-carbohydrate diet in the treatment of type 2 diabetes.

Apollinaire Bouchardat (1806–1886), who is sometimes called the founder of modern
diabetology, established his own therapeutic diet based on the observation that periodic
starvation during the Franco-Prussian War of 1870 reduced urinary glucose. His book, De la
Glycosurie ou diabète sucré (Glycosuria or Diabetes Mellitus) laid out his comprehensive
dietary strategy, which forbade all foods high in sugars and starches.

In 1889, Dr. Josef von Mering and Oskar Minkowski at the University of Strasbourg
experimentally removed a dog’s pancreas, the comma-shaped organ between the stomach
and intestine. The dog began to urinate frequently, which Dr. von Mering astutely recognized
as a symptom of underlying diabetes. Testing the urine confirmed the high sugar content.
In 1910, Sir Edward Sharpey-Schafer, sometimes regarded as the founder of
endocrinology (the study of hormones), proposed that the deficiency of a single hormone he
called insulin was responsible for diabetes. The word insulin came from the Latin insula,
which means “island,” as this hormone is produced in cells called the islets of Langerhans in
the pancreas.
ASHORT HISTORY OF DIABETES ASHORT HISTORY OF DIABETES Reviewed by Leembo on March 02, 2019 Rating: 5

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