History of Diabetes - Part 1 | डायबिटीज का इतिहास

History of Diabetes

Diabetes is not a disease but a simple disorder that can be managed at home easily. The easy way to understand the difference between disease and disorder is that Disease is caused by external factors that are not in our control, whereas disorder is caused by internal factors that are in our control. These internal factors may include our eating habits, food selection, and thoughts in the mind. The main internal cause of diabetes is our eating habits, which include food that contains high carbohydrates, and we also live an unhealthy lifestyle. 

Even today people believe that diabetes cannot be reversed, and still believe that a diabetic will remain diabetic for life, but this is not true anymore. You can start reversing your diabetes at home easily with a carbohydrate-restricted healthy diet and disciplined lifestyle. To understand the concept of diabetes reversal let's walk through the pages of history. So, fasten your seat belts, we are ready to drive. 

Ancient beginnings: from ancient Egypt to Greece

Let's begin our journey from the starting point in history and that is the origin of diabetes. The first mention of diabetes can be found in ancient Egypt. The word "diabetes" originated from the Greek word "siphon," where siphon means the flow of water through a funnel, which describes the condition of frequent urination. This means the person keeps urinating frequently but cannot understand why, so they named this diabetes.

Aretaeus of Cappadocia

Indian history of diabetes

History of diabetes in India is our next stop. Ayurveda which has a history of 6000 years has mentioned diabetes. Ancient Indian literature described conditions of diabetes as Prameha 'Pra' meaning abundant, and 'Meha' meaning 'passing of large quantities of Urine. References to Diabetes can be found in Sushruta Samhita (about 600 BCE), an ancient Sanskrit text on medicine and surgery. Where Patients complained of large quantities of urination accompanied by increased hunger, and sudden weight loss.

Sushruta is considered the "Father of Plastic Surgery." He lived in India sometime between 1000 and 800 BC and was responsible for the advancement of medicine in ancient India.

Diabetes mellitus and beyond: - the Middle Ages 

One day a patient eventually informed the doctor about the gathering of the ants at the site of urination. The doctor examined the patient's condition but was unable to diagnose it, so he took a urine sample and sent it to people known as "water tasters' ' who diagnose diabetes by tasting the urine of people. If urine tastes sweet, diabetes is diagnosed.

In the year 1675, Thomas Willis for the first time added the term "MELLITUS" with DIABETES to describe the characteristic symptom—which is the sweet taste of diabetic urine. 

In the ancient Indian texts this was described as Madhumeha, where ‘Madhu’ means honey and ‘meha’ means passing of large quantities of urine.  

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Different theories of diabetes in the past

The lack of knowledge and research on diabetes made people believe in various theories at that time but later they were all found to be wrong.

Some popular and accepted theories of those days are here: -

• People used to think that diabetes is caused due to some problem with the kidneys. They believed that kidneys are not able to store water which is causing frequent urination. Even though the person drinks a lot of water, he is still thirsty all the time. 

• Another popular theory was that diabetes is a digestive system condition. They believed that the body cannot properly digest and utilize food, which causes extreme hunger, but even after repetitive eating, he is losing weight.

• Other groups of people believe that diabetes is a neurological condition caused by brain dysfunction, which is the main cause of the disorder and its symptoms. Due to a lack of knowledge, some also believe that it is caused by evil spirits, they are made to believe that diabetes is a curse and that no one can escape that.

Nevertheless, these theories were among the numerous that were widely accepted at the time. Due to the lack of education, diabetes was poorly understood and there were no proven remedies.

Starting of a new era: early insights into treatment

When the above-mentioned theories failed to produce evidence to back their theories up scientifically. Researchers proceeded with the symptomatic treatment of individuals. Symptomatic treatment is a type of treatment where the physician treats the observed symptoms when the disease's real cause is unknown. Till now it is a popular practice and widely employed. 

They started with observational studies such as fasting, in which the patient's nutrition is restricted or withheld for some time until the frequent flow of urine normalizes. Positive findings from this study further encouraged the researchers to carry out more research. 

A doctor named John Rollo highlighted how a proper meat-based diet can cure diabetes. Along with that, he was the first to advocate a carbohydrate-restricted diet for diabetes treatment, he was also the first person to address the management of diabetes with food. Although the concepts of carbohydrates, proteins, and fats were not well-known at the time, people now tend to agree with him.

The major breakthroughs

In the year 1800, both industrialization and scientific progress were booming. The European scientific community was putting all its efforts into finding a cure for diabetes. Years of research and knowledge led them to some breakthroughs and they are: -

• As per Claude Bernard's theory from 1857, Diabetes is caused by the liver producing too much glucose. 
• In 1889, German physician Oskar Minkowski made a groundbreaking discovery when he found that removing the pancreas from dogs developed the symptoms of diabetes. This discovery laid the foundation for understanding the role of the pancreas in the disease.
  
• Goerge Zuelzer performed a trial in 1909 using pancreatic extract injections on diabetic patients. The results indicated a successful response in lowering blood glucose levels initially, but impurities led to the development of side effects like fever among the patients.
•  In 1910, Sir Edward Albert Sharpey-Shafer suggested only one chemical was missing from the pancreas in people with diabetes. He decided to call this chemical insulin, which comes from the Latin word insula, meaning “island.” 
• Frederick Grant Banting and Professor John James Richard MacLeod won the Nobel Prize in 1923 for the discovery of insulin. Which eventually decreased the blood sugar levels.
• Later, various oral antidiabetic medicines were introduced to reduce the rising of blood glucose levels. 

 Present scenario

 If a lower level of insulin was the only cause of diabetes, then the number of diabetic patients would have come down with insulin therapy. But it’s not happening, According to reports published by the Madras Diabetes Research Foundation and the Indian Council of Medical Research, there are about 101 million diabetic and 136 million pre-diabetic patients and still counting to date in India. India ranks at the number 2 position after China in terms of diabetic patients. So, it is quite clear that something is still missing in the treatment and management of Diabetes. 

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In our next blog, we will continue with HISTORY OF DIABETES (PART 2) Until then stay healthy