Grabbing the golden ring

Insulin, glucose meters and the control of an ancient disease

Mary Beth Gardiner
Published: July, 2003

Pictured above: Dr. Frederick Banting (top) and Charles H. Best, co-discoverers of insulin.
Photos courtesy of Eli Lilly and Company Archives
A century ago a diagnosis of diabetes was a death knell. There was little a physician could offer in the way of help, other than home remedies and desperation diets that only slowed the inexorable wasting of flesh to skin and bone. Opium dulled the anguish.

The discovery of insulin in 1921 was as close to a medical miracle as humanity has seen. The Lazarus-like recovery following injection of the pancreatic extract into a child lying literally on his or her deathbed seemed surreal. Within weeks, hollow cheeks turned plump and pink, frail limbs supple and sturdy.

Initial exuberance was tempered, however, as it became clear that although insulin might pull a person from the brink of death, it was not a cure. And the treatment wasn’t perfect — the injections caused bruising and painful abscesses. Maintenance of the syringes was elaborate and time-consuming. Monitoring of urine sugar levels was crude and cumbersome. And because nutritional thinking of the day said that carbohydrates could not be tolerated, physicians exhorted patients to drink quarts of cream and eat thrice-boiled vegetables, saccharin-flavored agar, and up to 60 grams of meat a day to restore vitality.

Managing the disease left little time for enjoying life.

Today, there is still no cure, but living with diabetes isn’t nearly the struggle it once was. Thanks to the efforts of countless basic and clinical researchers over the past hundred years, what we know about the disease — what goes awry in the body and how to prevent or control it — has expanded remarkably.

The long line of incremental discoveries that brought us to our current understanding of diabetes extends back more than two thousand years. The Ebers’ Papyrus, which dates from 1552 B.C. Egypt and is our oldest preserved medical document, noted the most prominent symptom of the disease, frequent and voluminous urination accompanied by excessive thirst and emaciation. In the first century A.D., Aretaeus coined the name diabetes from the Greek word for “pipe-like,” and described the affliction as a “melting down of flesh and limbs into urine.”

The association between sugar and diabetes was initially recognized in the sixth century by an Indian physician, Susruta, who wrote of diabetes as the honey urine disease. Gradually, the Latin word for sweet — “mellitus” — was added to distinguish the disease from Diabetes insipidus, a pituitary disorder in which large volumes of sugar-free urine are passed.

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