The disease of diabetes mellitus has been described since antiquity. The earliest known record is in an Egyptian papyrus dating from around 1500 BC. The Greek physician Aretaeus of Cappadocia named the disease 'diabetes' in the first century AD and described the short and painful life of sufferers: 'it consists in the flesh and bones running together into urine; the patients are tortured with an unquenchable thirst; the whole body wastes away...'. It is often claimed that the English physician, Thomas Willis, was the first to notice the sweet taste of the urine in 1679, but this fact is actually recorded in much earlier writings from the East. Indian medical writings, for instance, noted that ants find a particular interest in the urine of sufferers. The same writings also distinguished the two types of sufferer: young and thin, or older and overweight.
Important milestones in understanding the disease occurred in the nineteenth century. These were the discovery of the islets of Langerhans in the pancreas in 1869 (see Section 5.2.1), and the observation by Oskar Minkowski and Joseph von Mering in Strasbourg in 1889 that removal of a dog's pancreas led to diabetes. This was a chance observation, made whilst they investigated the role of the pancreas in fat absorption. Minkowski and von Mering also noted that if they attached a small piece of pancreas to the inside of the abdominal cavity, the dog did not develop diabetes; and this led to the idea that the pancreas produced a substance that was essential for normal metabolism. The name insulin was given to this hypothetical substance by the English physiologist Edward Sharp-
ey-Schafer, from insula, the Latin for island. By that time, a link between the diabetes and destruction of the pancreatic islets was suspected. This was based partly on the observations of an American pathologist, Eugene Opie, at the turn of the century, that the islets were destroyed in the pancreas of patients who had died of diabetes - which was then, of course, a fatal disease. In 1921 in Toronto Dr Frederick Banting and Charles Best, a medical student assisting him, made an extract of pancreas which, when injected into a dog (called Marjorie) made diabetic by removal of her pancreas, restored her to health. Production of this extract from the pancreases of cows and pigs was increased as rapidly as possible and it was soon made available (at first in small quantities) for treatment of human sufferers. The first person to be treated was a 14-year-old boy, Leonard Thompson. For such people it was a life-saving treatment (Fig. 10.1).
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Diabetes is a disease that affects the way your body uses food. Normally, your body converts sugars, starches and other foods into a form of sugar called glucose. Your body uses glucose for fuel. The cells receive the glucose through the bloodstream. They then use insulin a hormone made by the pancreas to absorb the glucose, convert it into energy, and either use it or store it for later use. Learn more...