November is Diabetes Awareness month not just in Canada but across the world. It is a month devoted to increasing awareness about this chronic disease and promoting efforts to raise money for ongoing research. Actually, more than just making people aware we need to raise the alarm about the epidemic of diabetes. Currently, 1 in 3 Canadians live with diabetes or prediabetes and it is rising at unprecedented rates. The yearly cost to our health care system to treat diabetes and associated complications is about $30 billion dollars (2019).
2021 is a highlight year as it marks the 100th anniversary of the discovery of insulin. Before this discovery, people with Type 1 diabetes rarely lived more than a year or two. I have to say, when I learned that insulin has only been around for a hundred years, it surprised me - that is really not that long ago! This actually prompted me to start reading more about the history of diabetes and how it has been treated over the years. I decided that looking back was a good way to kick off our Diabetes Awareness month.
1552 BC - the first known symptoms of diabetes were documented by an Egyptian physician Hesy-Ra, who wrote about a mysterious disease that caused frequent urination & emaciation (being abnormally weak or thin). Also around this time it was noted by ancient healers that ants were attracted to the urine of people who had this disease.
150 AD- the Greek physician Arateus described what we now know as diabetes as "the melting down of flesh & limbs into urine.” From this point on, physicians began to gain a better understanding of this disease.
Centuries later, people known as "water tasters'' diagnosed diabetes by tasting the urine of people suspected of having it. If urine tastes sweet, diabetes was diagnosed. How would you like that job on your resume?
In 1675, the word “mellitus” was added to describe diabetes. The full name of the disease is diabetes mellitus. It is derived from the Greek word diabetes meaning siphon-to pass through and the Latin word mellitus meaning honeyed or sweet. This is because in diabetes excess sugar is found in the blood as well as the urine. It was known early on as the "pissing evil". It wasn't until the 1800s that scientists developed chemical tests to detect the presence of sugar in the urine.
As physicians learned more about diabetes they began to understand how it could be managed. The first treatment involved prescribed exercise, often horseback riding, which was thought to relieve excess urination. In the 1700s & 1800s, physicians began to realize that dietary changes could help manage diabetes. Patients were advised to do things like eat only the fat and meat of animals. During the Franco-Prussian war, Dr. Apollinaire noted that his diabetic patients' symptoms improved due to war rationing. He then developed individualized diets as treatment for the disease. This led to fad diets in the early 1900s which included "potato therapy" or "oat cure".
In 1916, Dr. Elliot Joslin established himself as one of the world's leading diabetes experts. He created a textbook about diabetes treatment which reported that a fasting diet combined with regular exercise could reduce the risk of death in diabetes. These principles about lifestyle changes are still followed by diabetes educators & physicians today.
Despite these advances, until the discovery of insulin, diabetes led to premature death. The first big breakthrough that eventually led to the use of insulin to treat diabetes was in 1889 when French researchers, Minkowski & Mering, showed that the removal of a dog's pancreas could cause diabetes. In the early 1900s, Zuelzer, a German scientist, discovered that injecting pancreatic extract into patients could control diabetes.
In 1920, Canadian physician Frederick Banting, first had the idea to use insulin to treat diabetes and he and his team began testing the theory in animal experiments. Banting & his team finally used insulin to successfully treat a diabetic patient in 1922. They were awarded the Nobel Prize in Medicine the following year. This was one of the greatest medical breakthroughs in history - a very proud moment in Canadian history for sure. The patient they treated, Leonard Thompson was 14 at the time & he lived another 13 years.
In 1936, Sir Harold Percival published research that differentiated between Type 1 & Type 2 diabetes. He theorized that some patients had insulin resistance versus insulin deficiency. This resistance to insulin leads to the development of Type 2 DM.
We have made much progress since this time but insulin remains the mainstay of treatment for patients with type 1 diabetes. It is also an important therapy for patients with Type 2 diabetes when blood glucose cannot be controlled by diet, weight loss, exercise & medications.
Sadly, although we celebrate the 100th anniversary of the most celebrated Canadian medical discoveries of all time, and the treatment of diabetes has grown tremendously, diabetes is epidemic. Every 3 minutes another Canadian is diagnosed with this disease. Diabetes Canada put together a team of experts and advisory panels to come up with a national strategic plan to tackle diabetes called Diabetes 360. It is promising, and it highlights that Canada can no longer ignore the impact of diabetes on patients, families, employers, healthcare & the economy. We all need to get involved!
Cheryl Dechaine, RN