The term Diabetes is the shortened version of the full name DIABETES MELLITUS. Diabetes mellitus is derived from the Greek word diabetes meaning siphon (to pass through) and the Latin word mellitus meaning honeyed or sweet. Diabetes seems to be a very old disease. The oldest civilizations had a disease that resembles Diabetes in the medical literature. The Egyptians documents, Indian books and the Chinese documents describe a condition characterized by frequent urination, and sweet tasting of the urine.
Ancient History: The earliest written records of diabetes symptoms can be traced back to ancient civilizations. Egyptian, Indian, and Chinese texts described a condition characterized by frequent urination and sweet-tasting urine, which are classic symptoms of diabetes. However, they did not have a clear understanding of the disease's cause.
The first reference to diabetes can be traced back to the Ebers Papyrus. It is an Egyptian compilation of medical texts dated about 1550 BC. It is one of the oldest known medical documents. It mentions symptoms that could be interpreted as related to diabetes or other metabolic disorders. For example, conditions involving frequent urination or unusual compositions of urine.
Chinese medical texts dating back to ancient times also contain references to a condition resembling diabetes. These texts describe a condition characterized by excessive thirst, frequent urination, and sweet-tasting urine, which are classic symptoms of diabetes. While the ancient Chinese physicians did not have a clear understanding of the disease's underlying causes, they did make some observations and recommendations related to its management.
One of the earliest known Chinese texts that mentions diabetes-like symptoms is the "Huangdi Neijing" (黄帝内经), also known as the Yellow Emperor's Inner Canon, which dates back to the 2nd century BCE. This text is one of the foundational works of traditional Chinese medicine and contains descriptions of various diseases and their treatments. It mentions a condition called "Xiaoke" (消渴), which can be translated as "wasting-thirst," and is believed to refer to diabetes or a diabetes-like condition.
The treatment of Xiaoke in traditional Chinese medicine often involved dietary modifications, herbal remedies, and lifestyle recommendations, some of which are similar to modern diabetes management practices. For example, reducing the consumption of foods that were thought to exacerbate the condition, such as sweet and starchy foods.
Bitter Melon (Momordica charantia): Bitter melon is a well-known herb in TCM and other traditional medical systems. It has been used to help regulate blood sugar levels.
Cinnamon (Cinnamomum spp.): Cinnamon has been used in TCM to help improve insulin sensitivity and regulate blood sugar.
Fenugreek (Trigonella foenum-graecum): Fenugreek seeds have been traditionally used for their potential blood sugar-lowering effects.
Ginseng (Panax ginseng): Ginseng, a widely recognized herb in TCM, was sometimes recommended to help improve energy levels and overall well-being in individuals with diabetes-like symptoms.
Astragalus (Astragalus membranaceus): Astragalus has been used in TCM for its potential benefits in supporting the immune system and overall health, which can be important for individuals with diabetes.
Rehmannia (Rehmannia glutinosa): Rehmannia root is used in TCM to nourish Yin, a concept related to balancing the body's energy. It has been used in formulas for diabetes management.
Chinese Skullcap (Scutellaria baicalensis): Chinese skullcap has been used in TCM for its anti-inflammatory and antioxidant properties, which may be relevant for diabetes management.
Ayurveda approaches diabetes through a holistic lens, primarily focusing on diet, lifestyle modifications, and herbal treatments to manage and treat the condition. Diabetes in Ayurveda is referred to as "Madhumeha" and is classified under "Prameha," which encompasses all urinary disorders, including diabetes mellitus. The condition is believed to result from an imbalance of the doshas (fundamental bio-elements) in the body, particularly Kapha dosha, although Vata and Pitta also play significant roles.
Several Ayurvedic texts discuss diabetes (Madhumeha) and its management, including:
Charaka Samhita: One of the foundational texts of Ayurveda, it discusses the pathology, diagnosis, and treatment of various diseases, including Madhumeha. Charaka Samhita emphasizes dietary modifications, physical activity, and medicinal preparations for managing diabetes.
Sushruta Samhita: Another seminal text that complements Charaka Samhita, it is more focused on surgical techniques but also discusses various diseases, including diabetes. Sushruta categorizes Prameha (urinary disorders) into 20 types, with Madhumeha being one of them, and outlines treatments based on herbal formulations, diet, and lifestyle changes.
Ashtanga Hridayam: This text provides a comprehensive overview of Ayurvedic medicine, summarizing the teachings of both Charaka and Sushruta. It includes discussions on the causes, symptoms, and treatments of diabetes, highlighting the importance of a balanced diet and herbal remedies.
Madhava Nidana: Focused on diagnostics, this text offers insights into the early detection of diseases, including Madhumeha. It details the symptoms and diagnostic methods for diabetes and other urinary disorders.
Bhava Prakasha: This later text compiles knowledge from earlier works and introduces new concepts and treatments. It discusses diabetes within the broader context of Prameha, offering detailed information on herbal remedies and dietary recommendations.
Greece and Rome:
The word "diabetes" comes from the Greek word "siphon," referring to excessive urination. Greek physicians such as Aretaeus of Cappadocia (2nd century AD) and Roman physician Galen (2nd century AD) made important contributions to the early understanding of diabetes, though their understanding remained limited.
Claudius Galen (c. 130–210 AD), a prominent ancient Greek physician, made notable contributions to the understanding of various medical conditions, including diabetes. Galen did not use the term "diabetes" as we do today, but he described a condition associated with excessive urination and sweet-tasting urine, which aligns with what we now recognize as diabetes. In his works, Galen identified a condition called "diuresis," which refers to the increased production of urine. He observed that the urine in individuals with this condition had a sweet taste.
During the Middle Ages, diabetes was often associated with a sweet taste in urine, and it was called "the pissing evil." Physicians attempted various treatments, including dietary changes and herbal remedies, but with limited success. The term Diabetes was recorded in English for the first time in a medical text written around 1425. In 1675 that Thomas Willis added the word “’mellitus’” to the word diabetes. This was because of the sweet taste of the urine.
Thomas Willis, an English physician, and anatomist is credited with coining the term "diabetes mellitus" (mellitus meaning "honey-sweet" in Latin) in the late 17th century. He recognized that the urine of people with diabetes had a sweet taste due to the presence of excess sugar.
In the 19th century, advancements in scientific understanding led to further progress in diabetes research. In 1869, Paul Langerhans, a German pathologist, discovered the pancreas contains small clusters of cells that we now know as the islets of Langerhans. It was later found that these islets contain beta cells, which produce insulin.
Joseph von Mering and Oskar Minkowski in 1889 discovered the role of pancreas in diabetes. They found that dogs whose pancreas were removed, developed all the signs and symptoms of diabetes and died shortly afterwards.
Early 20th Century:
In 1910, Sir Edward Albert Sharpey-Schafer found that diabetes resulted from lack of insulin. He termed the chemical regulating blood sugar as insulin from the Latin “insula”, meaning island, in reference to the insulin-producing islets of Langerhans in the pancreas. In 1921 Sir Frederick Grant Banting and Charles Herbert Best purified the hormone insulin from the pancreas of cows at the University of Toronto. This led to the availability of an effective treatment for diabetes in 1922.
In 1921, a significant breakthrough occurred when Canadian researchers, Frederick Banting, Charles Best, John Macleod, and James Collip, successfully isolated insulin from the pancreas of dogs and used it to treat diabetes in humans. This discovery revolutionized diabetes management and saved countless lives.
In 1936 Sir Harold Percival (Harry) Himsworth published his work that differentiated type 1 and 2 diabetes as separate entities.
Mid-20th Century: With the availability of insulin therapy, the understanding of diabetes improved, and better methods of diagnosis and treatment were developed. Blood glucose monitoring techniques also advanced during this period.
Late 20th Century: Research into the pathophysiology of diabetes and the development of various oral antidiabetic medications, such as metformin and sulfonylureas, expanded treatment options for people with type 2 diabetes.
The first biosynthetic human insulin – Humulin – that is identical in chemical structure to human insulin and can be mass produced was approved in 1982 to market in several countries.
The 21st century has seen further advancements in diabetes management, including the development of more sophisticated insulin delivery systems, continuous glucose monitoring (CGM), and artificial pancreas systems. Research into genetics, lifestyle factors, and the role of obesity in diabetes has also expanded our understanding of the disease.