History of diabetes

The condition known today as diabetes (usually referring to diabetes mellitus) is thought to have been described in the Ebers Papyrus (c. 1550 BC). Ayurvedic physicians (5th/6th century BC) first noted the sweet taste of diabetic urine, and called the condition madhumeha ("honey urine"). The term diabetes traces back to Demetrius of Apamea (1st century BC). For a long time, the condition was described and treated in traditional Chinese medicine as xiāo kě (消渴; "wasting-thirst"). Physicians of the medieval Islamic world, including Avicenna, have also written on diabetes. Early accounts often referred to diabetes as a disease of the kidneys. In 1674, Thomas Willis suggested that diabetes may be a disease of the blood. Johann Peter Frank is credited with distinguishing diabetes mellitus and diabetes insipidus in 1794.

In regard to diabetes mellitus, Joseph von Mering and Oskar Minkowski are commonly credited with the formal discovery (1889) of a role for the pancreas in causing the condition.^[1] In 1893, Édouard Laguesse suggested that the islet cells of the pancreas, described as "little heaps of cells" by Paul Langerhans in 1869, might play a regulatory role in digestion. These cells were named islets of Langerhans after the original discoverer. In the beginning of the 20th century, physicians hypothesized that the islets secrete a substance (named "insulin") that metabolises carbohydrates. The first to isolate the extract used, called insulin, was Nicolae Paulescu. In 1916, he succeeded in developing an aqueous pancreatic extract which, when injected into a diabetic dog, proved to have a normalizing effect on blood sugar levels. Then, while Paulescu served in army, during World War I, the discovery and purification of insulin for clinical use in 1921–1922 was achieved by a group of researchers in Toronto—Frederick Banting, John Macleod, Charles Best, and James Collip—paved the way for treatment. The patent for insulin was assigned to the University of Toronto in 1923 for a symbolic dollar to keep treatment accessible.

In regard to diabetes insipidus, treatment became available before the causes of the disease were clarified. The discovery of an antidiuretic substance extracted from the pituitary gland by researchers in Italy (A. Farini and B. Ceccaroni) and Germany (R. Von den Velden) in 1913 paved the way for treatment. By the 1920s, accumulated findings defined diabetes insipidus as a disorder of the pituitary. The main question now became whether the cause of diabetes insipidus lay in the pituitary gland or the hypothalamus, given their intimate connection. In 1954, Berta and Ernst Scharrer concluded that the hormones were produced by the nuclei of cells in the hypothalamus.