In light of World Diabetes Day today, we take a look at the evolution of modern medicine’s ability to better understand and treat this debilitating metabolic condition.

Its beginnings in ancient Egypt

1552 BC – The earliest known record of diabetes was written on papyrus by Egyptian physician Hesy-Ra, who mentioned frequent urination as a symptom.

1500 BC — Ancient Indians tested for diabetes by determining if ants were attracted to a person’s urine.

250 BC — Apollonius of Memphis came up with the term “diabetes”; meaning to go through, referring to a disease that drains patients of more fluid than they can consume.

1st Century AD
– In Greek, “diabetes” means “to pass through.” The Greeks described the disease as “a melting down of the flesh and limbs into urine.”

164 AD
– Galen of Pergamum, a known Greek physician, diagnosed diabetes as a kidney ailment.

16th Century
– Diabetes is identified as a serious general disorder by Paracelsus.

The distinction between type 1 and Type 2 diabetes

1776 – English physician Matthew Dobson, makes the distinction between Type 1 and Type 2 diabetes for the first time.

– Scottish physician John Rollo successfully created the first medical therapy to treat diabetic patients by using a high fat and protein diet.

Development of the first diabetes chemical test

Early 1800′s – First chemical tests were developed by researchers to indicate and measure the presence of sugar in urine.

– Claude Bernard made the first linking between diabetes and glycogen metabolism.

– The link between diabetes and the pancreas was established when Oskar Minkowski discovered that a dog from which he removed the pancreas from had
developed the illness.

The miraculous discovery of Insulin

1921 – Canadian surgeon Frederick Banting’s work leads to the discovery of insulin. On July 30, Dog 410 is the first to receive the extract. On August 4, the extract is called ‘Isletin’ for the first time. News of the miraculous discovery began to spread across the world.

Before the discovery of insulin, being diagnosed with diabetes was equivalent to a death sentence with patients lasting no more than three or four years at most.

First mass production of Insulin

1922 – A 14-year-old patient, Leonard Thompson, is the first to receive an insulin injection to treat diabetes at the Toronto General Hospital. In the same year, the University of Toronto and Eli Lilly strike a deal for the mass production of insulin in North America.

– Frederick Banting and his colleague, Macleod, are awarded the Nobel Prize in Physiology or Medicine.

Development of the first home sugar testing kit

1925 – The first home testing for sugar in the urine is introduced.

– Insulin is further refined by the introduction of Protamine zinc insulin, a long acting insulin that provides greater flexibility for diabetics.

– The connection between diabetes and long-term complications such as kidney and eye disease is made.

– Diabetes management becomes more standardized with the development of the insulin syringe.

Innovations in treatment: Development of the first blood glucose meter and insulin pump

The 1950s to 1980s marked a turning point in the treatment of diabetes. Innovations gave diabetes patients and their doctors some indispensable tools.

– The introduction of oral drugs that help lower blood glucose levels.

– Development of strips for testing of blood glucose.

– Instant glucose is developed.

Insulin pumps and the first blood glucose meter is first developed for use in doctors’ offices. The insulin pump was made to imitate the body’s usual release of insulin. The first glucose meters were large in size and since then the size has been reduced to the portable glucose meters which we know of today. 1970 also marks the year laser therapy was introduced to help prevent blindness resulting from diabetes.

– Introduction of U-100 insulin.

– Introduction of the HbA1c test.

– Introduction of the first biosynthetic human insulin by researchers at the City of Hope National Medical Center in San Francisco. E. coli bacteria was induced by the researchers to produce insulin identical to human insulin.

– Introduction of the insulin pen delivery system.

– Introduction of instant glucose tablets.

– Marks the 75th anniversary of the discovery of insulin. Also the year in which the first recombinant DNA human insulin analogue, lispro is approved by the Food and Drug Administration (FDA). Lispro’s fast-acting tendencies meant that patients can take this insulin 15 minutes or less before their meal, rather than waiting longer if they were taking the regular insulin.

Transformation of diabetes care

1998 – A study done by the United Kingdom Prospective Diabetes Study (UKPDS) showed that people with type 2 diabetes can reduce their risk of developing complications by practicing tight control of their blood sugar and blood pressure levels. These studies have transformed diabetes care the world over.

– Diabetes is recognised as a global threat by the United Nations and November 14 is designated as World Diabetes Day – in honour of Frederick Banting’s birthday.

Now a worldwide epidemic

2010 – Marks the 90th anniversary of Banting's breakthrough discover of insulin.

- The World Health Organisation (WHO) reported that diabetes was the direct cause of close to 1.5 million deaths in the world.

– The Food and Drug Administration (FDA) approves Invokana (Canagliflozin) that helps lower elevated blood sugar levels in patients with type 2 diabetes. The SGLT-2 inhibitors inhibit the activity of sodium glucose transport proteins in the kidney thus, reducing glucose re-uptake and increasing secretion of glucose in the urine.

– The WHO reported that the number of people with diabetes around the world continues to increase from 108 million in 1980 to 422 million in 2014. It is noted that diabetes is especially prevalent in low and middle-income countries compared to high-income countries due to poor management of the diseases and lack of access to medical care. MIMS

Read more:
Infographic: The history of diabetes across the centuries
World’s first “artificial pancreas” approved for Type 1 diabetes treatment
Breaking down the Global Burden of Disease report
NTU develops new kit that measures inflammation status in diabetic patients
Type 2 diabetes risk linked to marital status and long naps