History

2. History

Diabetes mellitus was first described in an ancient Egyptian papyrus dating from the second millennium B.C. An Egyptian priest had observed that the urine of people afflicted by a disease of weight loss and excessive urination attracted insects, particularly bees and ants. Over the centuries, various other authors described a similar phenomenon without completely characterizing the disease or naming it.

It was the Greeks who characterized the excessive urination and the siphoning effect, or “the melting of the body through the loins” (weight loss and polyuria). A few centuries later, the Romans added the name mellitus, presumably because some enterprising physician gave the urine the taste test, discovering for sure its sugar content.

There were few developments that advanced our understanding of diabetes over the next millennium and a half. In more modern times, various diets were tried, some of them quite horrible. The rancid fat diet, popular in France in the 18th and 19th centuries, is one such example.

Scientific progress in our knowledge of diabetes began in the 18th century with the development of the microscope and Langerhan’s description of the beta cell containing islets in the pancreas. Subsequent pathologists such as Virchow (1821-1902) and others then described the lesions of the pancreas, leading Minkowsky (1858-1931) to hypothesize that the pancreas was somehow involved in diabetes. Minkowsky then performed pancreatectomy in animals and produced diabetes. This experiment led to the speculation that the pancreas continued an internal secretion whose deficiency was responsible for the disease. Many experienced investigators searched in vain for the internal secretion of the pancreas. All efforts were thwarted because the enzymes of the exocrine pancreas digested the beta cells.

In the summer of 1921, Dr. Fredrick Banting devised a way of ridding the body of the exocrine pancreas while preserving functioning beta cells. Charles Best, a young graduate student working with Dr. Banting that summer, developed the alcohol techniques for extracting the hormone from the remaining pancreatic tissue and for measuring blood glucose. In August 1921, after several failures, an extract of pancreas produced a dramatic drop in blood glucose in a diabetic dog, thus the internal secretion of the pancreas had been isolated.