Among the evocative descriptions of a disease, a stand-out comes from traditional Chinese medicine. "Wasting-thirst" aptly suggests a constellation of symptoms that goes with diabetes. The list includes excessive thirst, lethargy and persistent hunger, plus a few more.
One can only be amazed by the dedication of the Indian physicians in the 5th century BCE who called the condition "madhumeha". We get a sense of their deep commitment when the label is translated to "honey urine". Apparently, diabetic urine tastes sweet.
Diabetes has long been known by many cultures, with an ancient papyrus scroll from around 1550 BCE being the oldest known reference.
The Greek physician Apollonius of Memphis coined the term "diabetes" in 250 BCE. Like the Chinese, he noticed excessive urination - the Greek word "diabainein" means "to pass through".
In 1889 it was found that the pancreas was involved and soon after, that was refined to the "little heaps of cells" identified by Paul Langerhans in 1869. The islets of Langerhans were named in his honour.
It's now well established that these cells secrete the insulin that metabolises carbohydrates.
Until the early 1920s, Type 1 diabetes was almost a death sentence. Half perished within two years, and 90 per cent by five years.
Since doctors couldn't stop the disease, the only treatment was a starvation diet... basically, stop eating.
The picture changed in 1921 when researchers at the University of Toronto discovered how to produce insulin.
They extracted insulin from a dog's pancreas, which lowered blood sugar in another diabetic dog. Months later, they injected a purified extract into a dying 14-year-old boy.
His blood sugar fell, and he was soon eating normally. His strength returned and he was able to go home.
Now it's becoming clear that the body is more than a collection of organs. Each interacts with the others in a complex ecology.
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Diabetes does not occur in isolation because it affects the entire body and, in 2023, the American Heart Association grouped it with other conditions under a single name: cardio-kidney-metabolic syndrome (CKM).
Fat cells secrete a medley of inflammatory compounds that can damage the kidneys, muscles, heart and other organs. A cascade of other effects follows, and people with diabetes are two to four times more likely to develop heart disease.
Luckily, a new series of drugs ("GLP-1 medications") is showing great promise. A 2024 trial was stopped early because the benefits were so overwhelming it was unethical to continue giving a placebo to the control group.
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