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History

Ancient Diabetes

The first record of diabetes comes from ancient times. Specifically, a papyrus dating back to the seventeenth dynasty (1650 – 1532 BC) that was found in a tomb in Thebes in 1862. This is the earliest known document that records diabetes.

The Ebers papyrus, named after the Egyptologist that discovered it, contains descriptions of numerous diseases encountered during that time. For one disease, the papyrus describes a polyuric state, or frequent urination. The described disease resembles that of diabetes mellitus – as it is known today (Type 1).

Fast forwarding to the second century AD (101 – 200 AD), the term diabetes was first coined by Aretaeus of Cappadocia. The term “diabetes” is Ionian Greek and translates to “siphon” as a noun, or “to run through” as a verb. What is really incredible about Aretaeus is his remarkably accurate description of the disease state.

Image result for aretaeus of cappadociaDiabetes is a dreadful affliction, not very frequent among men, being a melt down of the flesh and limbs into urine. The patient never stops making water and the flow is incessant, like opening an aqueduct. Life is short, unpleasant and painful, thirst unquenchable, drinking excessive and disproportionate to the large quantity or urine, for yet more urine is passed.One cannot stop them either from drinking or making water. If for a while they abstain from drinking, their mouths become parched and their bodies dry; the viscera seem scorched up; the patients are affected by nausea, restlessness, and a burning thirst, and within a short time, they expire.[1]                                   

Image result for claudius galenus pictureA Roman physician from the second century AD, Claudius Galenus, also wrote about diabetes. He called diabetes “diarrhea urinosa” and “dipsatos”. Diabetes was such a rare occurrence during this time that Claudius Galeunus apparently only encountered two cases. His records emphasize the scarcity of the disease and the same symptoms described by Aretaeus and the Ebers papyrus. 

It wasn’t until the fifth and sixth century AD (401 – 600 AD) that physicians began to record a “sweet” taste in the urine of diabetic patients. In fact, the Sanskrit literature is the first known documentation to make this correlation. They described the urine as being sticky, tasting like honey, and attracting ants.  

During the same time period, Chinese and Japanese physicians were recording very similar observations to the Sanskrit literature. In addition to a polyuric state and sweet urine, they wrote about diabetic patients being prone to boils – a problem that is faced by those with diabetes today. 

Between the tenth and eleventh century AD (901 – 1100 AD), Arabic medicine was making great advancements. In Arabic texts, the sweet taste of the urine from those with diabetes was well documented. Moreover, Avicenna, the largest contributor to Arabic medicine during this time, made further observations of symptoms common with diabetes.  

Image result for avicennaAvicenna emphasized two complications related to diabetes that were prevalent during this time; gangrene and penile erectile dysfunction (PED). Both of these conditions can still occur to individuals with diabetes today. However, during Avicenna’s time these were most likely a much more grave concern.  

Because diabetes was such a rare occurrence during these ancient times, no real progress was made in treating the disease. Mainly, ancient physicians did great work to document the diseases and hypothesize potential treatments that seem foolish by today’s standards. It is important to note however, that until the discovery and production of exogenous insulin, diabetes was a fatal disease. Furthermore, even today we must continue to question the convention of the treatment of diabetes and continue to improve on the treatment and prevention of the growing epidemic. 

Diabetes in Recent Centuries

From the seventeenth century to the nineteenth century, European physicians were able to make great advancements in diabetes research. With diabetes becoming a more common disease, physicians had more patients with diabetes and more incentive to make progress toward better treatment. However, they were a little slow to get up to speed with some of the ancient knowledge on diabetes.Image result for thomas willis

In fact, Thomas Willis was the first European physician to record the sweet taste of diabetic urine in the seventeenth century. An observation made by ancient physicians thousands of years ago. Nonetheless, the unoriginal observation helped later doctors, such as Dr. Matthew Dobson, to further the research of diabetes.

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In 1776, Dr. Matthew Dobson was the first doctor to record that the blood of diabetics, similarly to urine, contained a sweet tasting substance. A substance he proved was sugar. This built on a theory proposed by Dr. Thomas Sydenham a century earlier. Dr. Sydenham hypothesized that diabetes was caused by undigested food in the blood stream. A quite remarkable hypothesis for the time. 

After the discovery of sugar in the blood of people with diabetes, physicians continued to clearly define diabetes. By being able to clearly identify a diabetic state by testing blood sugar levels, doctors were able to define specific symptoms relating to diabetes. Furthermore, physicians continued to study the biological causes and effects of diabetes. Specifically, where the undigested sugar came from and how the body dealt with it. 

Image result for Oskar Minkowski and Josef von MeringThen, one of the most important discoveries in the advancement of diabetic treatment was made in 1890.  At the University of Strasbourg, Oskar Minkowski and Josef von Mering established a connection between the pancreas and diabetes. They did this by preforming an experiment in which they removed a dog’s pancreas. Even though they were just testing whether or not the pancreas was a vital organ, what they found was revolutionary in the advancement of the treatment of diabetes. 

With today’s knowledge, it is no surprise that without a pancreas the dog immediately became diabetic. This led to a lot of focus on the pancreas in diabetes research. Soon after the experiment in 1909, a glucose regulating hormone was hypothesized by Dr. Jean de Meyer. He hypothesized that the hormone was produced in the islet tissue of the pancreas. Furthermore, he even named the hypothetical hormone “insulin.” 

For a relatively short period, researches continually attempted to treat diabetes using pancreatic tissue. Even though it was a logical solution based on the new found link between the pancreas and diabetes, it was not until 1922 that a break through was made. 

Insulin’s Discovery

Image result for dr frederick bantingUntil 1922, the existence of insulin had not been proven. However, doctors did know that there was a definite link between the pancreas and diabetes. Therefore, researchers continued attempting to treat diabetes with pancreatic tissue. Unfortunately many attempts failed due to inefficient extraction techniques. 

In 1920, Dr. Frederick Grant Banting developed a hypothesis for how to process pancreatic tissue in order to extract the theorized hormone, insulin. After convincing his colleague, Dr. J. W. Macleod, of his idea, Macleod provided Dr. Banting with experimental facilities and a medical student named Charles H. Best as an assistant. Banting and Best began experimentation in 1921. 

Image result for dr james b collipBanting and Best had little luck in the beginning. Even though they were getting some results, the researchers began to grow discouraged and requested help. Thus, Dr. James B. Collip, a renowned biochemist, was added to the team. 

In December of 1921, Banting and Best presented their inconclusive work to the American Physiological Society while Dr. Collip worked independently to refine Banting’s extraction technique. Banting and Best’s paper was heavily criticized. However, during the time Collip developed a technique of removing the toxic contaminants of Banting and Best’s extracts. 

Related imageUndaunted by the criticism received on their preliminary report, Banting and Best gave their extract to a fourteen year old boy dying from diabetes on January 12, 1922. The extract was an utter failure. On January 23, 1922, one of Collip’s refined extracts was given to the same boy. It worked! After taking Collip’s extract, the boys blood glucose went down to normal, sugar was not found in the boys urine anymore, and the boy was not dying from diabetes! 

Insulin was now finally discovered! Because of this discovery, people with diabetes are now able to treat their condition with exogenous insulin and prolong their life. Even though Dr. Collip’s technique was only capable of producing limited quantities of insulin, that problem was very quickly solved by a group of chemists at the Eli Lilly Company of Indiana. By October of 1923, insulin was being produced and distributed all of North America and Europe. 

Diabetes Today

As you can see it has been a long, hard road to get where we are today. It was only about 100 years ago that exogenous insulin was available for the treatment of diabetes. We are definitely fortunate to live in a time when diabetes is a better understood and treated disease. However, we are by no means done making advancements in the treatment and prevention of diabetes!

As discussed on the “The Epidemic” page of this site, metabolic diseases such as diabetes are rampant in American Society. Today it is a different story though. Rather than dealing with just Type 1, we have Type 2 running wild. This is the polar opposite of the situation in ancient times when diabetes was a scarce occurrence. Type 2 occurs when someone has a functioning pancreas, but other parts of the body are non-responsive to it. Even though we have more advanced medical treatment, we are currently faced with a problem that has not been prevalent in the past. Unfortunately, this is due to the adoption of the modern Standard American Diet (SAD). 

Visit the other pages of this website to learn more about our approach to defining and fixing diabetes. We mainly work with Type 2 Diabetes, but ketogenic diet therapy actually works really well with Type 1 as well. Sign-up for our Starter Guide and Newsletter if you want to get started right away! You will not be disappointed.

If you want to get started learning about the ketogenic diet, we suggest looking at the following pages:

We look into a promising solution to the epidemic. We introduce the idea of a Ketogenic Lifestyle and how it has the potential to change the course of diabetes as we know it. 

It is important to understand the history of diabetes before we begin to reshape the future! 

References:

[1] Papaspyros, N. (1964). The History of Diabetes Mellitus. 2nd ed. Thieme.

[2] Kraft, J. (2011). Diabetes epidemic & you. [Bloomington, Ind.]: Trafford Publishing.

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