April 14, 2003
Historical aspect of Diabetes mellitus
Ophthalmology Times March 15, 2003
Polyuria was mentioned in the Ebers Papyrus, which dates from about 1500 bc. Aretaeus, a physician who lived in Asia Minor, wrote an accurate clinical description of diabetes mellitus including the classical triad of polyuria, polydipsia, and polyphagia. He concluded that the name diabetes comes from the Greek word for siphon, meaning to go through or to pass through, and the word mellitus, coming from the Greek word for sweet. Thomas Willis (1621-1675) wrote of the sweetness of the affected patient's urine and likened it to honey. Further analysis of the urine of diabetics was performed by Matthew Dobson (1735-1784), who, in 1776, was the first to demonstrate the presence of sugar in the urine. Adolf Kussmaul (1822-1902), author, researcher, and scientist, in 1873 described the respiration that is associated with diabetic coma and has been termed Kussmaul's breathing or Kussmaul's air hunger. In 1890 Oskar Minkowski (1858-1931), a Russian by birth who studied medicine in Germany, carried out critical investigations of the role of the pancreas in diabetes mellitus. The final chapter in this story is set in Canada where Frederick Grant Banting (1891-1941) began his orthopedic surgical practice in 1920. He became interested at that time in the idea of extracting the acting principle responsible for causing diabetes from the pancreas. He left his practice to go to the University of Toronto and work at the laboratory of John James Rickard Macleod (1876-1935). Macleod gave Banting a small laboratory, 10 dogs, and the aid of an undergraduate student, Charles Herbert Best (1899-1978), who was well versed in the analysis of carbohydrates. In May 1921 they began their studies. On July 30, 1921 after tireless experimentation, they showed that there was an internal secretion of the pancreas that, when given to dogs that had previously had their pancreas removed, would control the diabetes that occurred. Banting called this substance isletin and later changed it to insulin. By January 1922 insulin was purified, and human clinical trials began. Within 6 months, 1 year after the beginning of their research, insulin would become available to the world. In 1923 the Nobel Prize in physiology or medicine was awarded to Banting and Macleod. Banting was 32 years old at the time and thus is the youngest recipient of the Nobel Prize in physiology or medicine. No mention of Best was noted. Banting was angered and wrote profusely about Best's participation in the studies. He showed his disappointment with the Nobel committee by sharing the monetary prize with Best. In 1934 Banting was knighted. On February 2, 1941, he was killed in an airplane crash while he was heading for England to help England in its World War II conflicts. The young Nobel Prize laureate died all too soon but left a legacy for which generations of diabetics are thankful.
Posted by mehdi khanlari at April 14, 2003 10:53 AM