The American Diabetes Association defined diabetes as “A group of metabolic disorders characterized by hyperglycemia resulting from defects in insulin secretion, insulin action or both”
‘Madhumeha’, the name identified by Indian physicians for diabetes in ancient years. The Indian physicians Charaka and Sushruta (400-500 CE) elaborated diabetes and its management. They also noticed sweetness in urine and blood of patients and noted that urine of diabetic person attracts ants. Hence they termed Diabetes as ‘Honey urine’ also. The term “Diabetes” means “to pass through” was first coined by Greek physician Aretaeus of Cappadocia in 2nd century A.D. ‘Mellitus’ means ‘Honey-sweet’.
Moreover, many references and descriptions of the history of diabetes are available in much older clinical writings across the world. In 1552 B.C, Egyptian physician Hesy-Ra described the conditions resembling diabetes which is considered to be the oldest reference appeared in medical texts of Ebers Papyrus.
It was the era when the human life expectancy was shorter than of today, and diabetes was considered to be fatal and incurable. The approach to diabetes management was completely dieting centric and calorie restricted.
The basic pathophysiology of diabetes was unknown till the time role of pancreas and insulin was not discovered.
The pancreas is the endocrine gland which produces certain hormones like insulin, glucagon, etc. These hormones play important role in the regulation of diabetes. The pancreas is the important part of the digestive system also as it produces certain enzymes that help to digest food. The pancreas was first discovered by Herophilus, a Greek anatomist, and surgeon (335-280 BC).
Another Greek anatomist, Rufus, coined the term ‘Pancreas’ which means ‘all flesh’ in Greek. In 1889, a Polish-German physician Oscar Minkowski and Joseph von Mering, discovered the role of the pancreas in the pathogenesis of diabetes. During an experiment, they removed the pancreas of a healthy dog and tested the urine; they found sugar content in dog’s urine. When the pancreas got removed from the dog, the dog got diabetic.
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Insulin is a hormone that produced by cells of the pancreas. Insulin assists cells to take up glucose and helps to regulate blood glucose levels. In 1869, a German Medical student, Paul Langerhans, found that the pancreas contains the cluster of cells which produces insulin. It was after Minkowski and Mering experiment on a dog, it was confirmed that the pancreas produces a hormone that plays a vital role in diabetes metabolism.
In 1922, Dr. Fredrick Banting, an orthopedic surgeon from Canada, discovered insulin. He approached Dr. John Macleod, University of Toronto, and professor of physiology, seeking help in the experiment on isolation of pancreatic islets in a dog.
John Macleod provided him a laboratory and an assistant Charles Best for the experiment. When they removed the pancreas from the dog, the dog developed diabetes.
Similarly, they first ligated the pancreatic ducts of another dog till degeneration and then isolated the islets. They took extracts of the degenerated pancreas, purified and then performed regular injections to a diabetic dog.
They named the extract as ‘Isletin’ which causes lowering the blood glucose of diabetic dog. There was a mild reduction in glucose levels. Further, research and studies were conducted on humans.
There was something that is secreted by the pancreas which helps to regulate blood glucose levels. For years of work, scientists succeed to crack the mystery and discovered insulin and its role in diabetes management.
When we look back on the history of diabetes, the role of pancreas and discovery of its hormone insulin is nothing less than a miracle.