Diabetes: An Ancient Disease

Researchers have found evidence of what could be described as diabetes dating back to about 1500 B.C. In later years records told of various members of the same family being afflicted with “sweet-water disease.”

In historic documents, patients who were obese and without energy were said to have maturity-onset diabetes, called Type 2 diabetes today. Type 1 diabetes was described as causing a melting down of the flesh and sweet urine.

In the 19th century, doctors learned the pancreas was made of clusters of little cells inside a sea of tissue. These clusters were known as the islets of Langerhans, named after the physician who discovered them. But there was no correlation between diabetes and the pancreas until 1889 when two German scientists, Joseph von Mehring and Oskar Minkowski, discovered that animals developed diabetes if their pancreases were removed. Researchers eventually narrowed down the destruction of islet cells as being the cause of the disease.

People with “sweet-water disease” still had no hope until Charles Best, a graduate student at the University of Toronto, and Frederick Banting, a surgeon, discovered insulin during a 1921 research project. They found that when they minced and purified islet cells from animals and injected them into a dog with diabetes, the blood sugar levels fell.

Insulin was then extracted from the pancreas of animals, and patients with diabetes had a new lease on life.

Although this was thought to be the answer to the problem, it was only the first door to open in a series that continues today. It eventually became apparent that intermittent doses of insulin were not enough. Questions arose. How often should insulin be given? Does something destroy its action? Why are there complications even with insulin therapy?

In 1949 Rachmiel Levine, a physician known as “the father of modern diabetes research,” discovered that insulin didn’t merely lower blood sugar but, instead, helped the sugar get into the cell. Levine continued working on diabetes research and treatment for more than 60 years. In 1978, under the direction of Levine, scientists at City of Hope National Medical Center near Los Angeles worked with scientists at Genentech, Inc., a San Francisco-based biotechnology and pharmaceutical company, to produce the first human insulin from recombinant (genetically engineered) DNA.

Today, people with type 1 diabetes have a choice of short- and intermediate-acting insulin and can take daily injections or use an insulin pump.

We now know that some people with type 2 diabetes produce plenty of insulin but it is not used properly by the body’s cells. New oral medications can stimulate the production of insulin or make it usable. Other medications work by slowing carbohydrate absorption to lower blood sugar or by reducing the production of glucose in the liver.

Researchers are continually making strides in diabetes testing and treatments. A new test allows doctors to determine if someone is likely to develop diabetes.

In addition, research continues on partial-pancreas and islet-cell transplants; a glucose meter that doesn’t require pricking the finger, and an artificial pancreas that uses actual beta cells (insulin-producing cells of the islets of Langerhans in the pancreas) to produce insulin.

There’s no cure for diabetes yet, but scientists are making progress every day. What used to be a fatal disease has become a condition that can be managed through medications and lifestyle adjustments.

MEDICINES FOR PEOPLE WITH DIABETES

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