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Wednesday, November 14, 2012

The History of Diabetes

  1. In 1500 BCE, ancient Egyptians recognized diabetes in people who urinated frequently and lost weight for no apparent reason. It was not labeled at that time but it existed.
  2. A Greek physician named Arateaus recognized that the urine produced from people with diabetes was sweet and termed it Diabetes Mellitus.
  3. In 1776, Matthew Dobson actually measured the urine for glucose and found it to be increased in certain people.
  4. In the early 1800s, diabetes was considered a clinical entity but the prevalence was not really documented. No specific treatment was used and usually within weeks to months the disease was fatal.
  5. The last 200 years have helped us understand many of the underlying causes of diabetes, ways to decrease risk factors of diabetes, and actual treatments. The outlook has definitely improved, with good results when therapies are used.
  6. Treatments have been effective, but still no real cure has been discovered.
  7. The disease of ancient times involved insulin deficiency (Type 1).
  8. In the early 1900s, Edward Sharpey-Schafer thought the lack of insulin was the cause of diabetes.
  9. Frederick Bating and Charles Best discovered insulin by reversing diabetes in dogs after inducing it. They did this by extracting pancreatic islet cells from healthy dogs; they later purified the insulin, and along with James Collip and John Macleod, were the first to treat a patient with diabetes using insulin.
  10. In 1936, Harold Himsworth proposed that more people had insulin resistance than insulin deficiency (Type 2).
  11. The discovery of biosynthetic human insulin replaced animal insulin, which eliminated reactions to insulin.
  12. Over the years we went from checking glucose in urine samples to using glucometers and checking blood sugar. In the beginning, blood glucose meter were only available in the hospital. Over time they became smaller, more sophisticated, and were made available for home use.
  13. New classes of oral diabetes medication have been discovered working on the pancreas, liver, muscle cells, gut hormones, and kidneys. Some that remain are cheap and reliable, and some are gone due to excessive side effects.
  14. Insulin injections went from glass syringes and long needles (which needed to be sterilized and reused), to disposable syringes with short, attached needles. Even easier are the disposable insulin pens which just require the click of a button.
  15. Pumps have made many lives much easier and eliminate the need for multiple daily shots. The added flexibility helps with an easier meal plan and exercise plan.
  16. Continuous Glucose Monitoring (CGM) assists people in identifying blood sugar trends, and is crucial for those who suffer from hypoglycemic unawareness.
  17. Ketone testing has gone from testing urine with strips to blood ketone testing, which is more efficient and reliable for testing for Diabetic Ketoacidosis (DKA).
  18. New injectable medications - called GLP1s - have been developed to not only assist with blood sugar control, but with appetite suppression and weight management - a huge asset for people with diabetes.
  19. Bariatric surgery has been added as a treatment for extremely overweight people with diabetes. Good results have been seen.
  20. New technology and medications are always being developed since diabetes is big business. The future looks bright. Hopefully we will gain progress in the fight against diabetes.
  21. On the darker side - 2012 shows that insulin deficiency (Type 1) accounts for 10% of diagnosed cases (autoimmune) which can be controlled with exogenous insulin (insulin injections). About 90% of the cases are considered insulin resistance (Type 2). This has become evident in the past 40 years and has created an epidemic world wide (causes may include inactivity, food portions and weight gain, along with genetics).
  22. The most recent statistics from the ADA are: 26 million people in the US have diabetes; 79 million have pre-diabetes with an increased risk for diabetes. One in three will have diabetes in 2050 if dramatic changes are not achieved. The yearly cost of diabetes to the nation is $174 billion.
  23. The need for a team approach with multiple follow up appointments has proven results, whether in person (one on one, class) or on the phone. Having a physician, CDE, dietitian, social worker, podiatrist, pharmacist and ophthalmologist is the best way to follow all the organ systems involved in diabetes.

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