There was diabetes over 100 years ago

History of diabetology

The history of insulin and insulin preparations is an important part of medical history, not least because the results of this research have made diabetes mellitus a deadly disease that has lost its horror.

Antiquity

Already around 100 AD Aretaios wrote: “Diabetes is a puzzling disease.” And he describes the symptoms and the course: “Diabetes is a terrible ailment, not very common in humans, a melting of the flesh and the limbs to urine ... Life is short, uncomfortable and painful, thirst is insatiable, ... and death is inevitable. "

17th century

In 1675, Thomas Willis describes the taste of urine in diabetes as "honey-sweet": "... tasted as if it has been mixed with honey". The name "mellitus" goes back to him; Diabetes mellitus was also called Willis' desease for a while. Willis also described the symptoms of diabetic neuropathy in his patients: "stinging and other (...) frequent contractions or convulsions, twinging of the tendons and other disturbancies" He could not cure diabetes: "It seems a most hard thing in this disease to draw propositions for curing, for that its cause lies so deeply hid, and hath its origin so deep and remote. " Although he observed that patients on an extremely hypocaloric diet temporarily felt better, he did not yet recognize the connections. In contrast to his colleagues, who viewed diabetes as a pure kidney disease, he already suspected that the cause must be in the blood.

In 1683 Johann Konrad Brunner Hunden removed the pancreas and observed extreme thirst and polyuria as a result; He is therefore considered to be the discoverer of pancreatic diabetes mellitus.

18th century

In 1776, the British doctor and natural philosopher Matthew Dobson (1732–1784) made a type of sugar in the urine responsible for its sweet taste.

In 1788, Cowley first described a connection between diabetes and diseases of the pancreas (Latin: pancreas).

In 1794, Johann Peter Frank first made the distinction between diabetes mellitus and diabetes insipidus.

19th century

In 1860 Joseph Alexander Fles (1819–1905) treated a diabetic with extracts from calf pancreas. In 1864 he published these experiments.

In 1869, Paul Langerhans describes the islet cells in the tissue of the pancreas in his dissertation; However, he does not examine their function.

In 1869 Langdon-Down reported on a treatment attempt with pancreatin (extract from ground pig pancreas, obtained from slaughterhouse waste).

In 1875 the French doctor Apollinaire Bouchardat published his work "De la glycosurie ou Diabète sucré son traitement hygiénique" in Paris, in which he laid out fundamental principles of diabetes treatment that are still important to the present day, including a special diet and the importance of weight reduction, physical Activity, metabolic control and patient education.

In 1880, the French doctor Étienne Lancereaux coined the terms diabete maigre (“lean diabetes”) and diabete gras (“fat diabetes”) in a publication, thus establishing the distinction between different forms of diabetes.

In 1889 Wilhelm Oliver von Leube describes the frequent connection between pancreatic diseases and diabetes mellitus.

In 1889, the German doctors Oskar Minkowski (1858–1931) and Joseph von Mering (1849–1908) removed the pancreas from dogs in order to observe the effect on lipid metabolism. In doing so, however, they discover that they are causing the disease diabetes mellitus.

In 1893, the French pathologist Gustave-Edouard Laguesse (1861-1927) called the cell accumulations in honor of Paul Langerhans "Ilots de Langerhans", "Langerhans islands". He also postulates their function as endocrine (hormone-producing) tissue with a regulatory effect on metabolism.

In 1893 Minkowski tried to supply a pancreatic extract by subcutaneous injection. Minkowski, Hédon and Thiroloix discover that after removal of the pancreas, diabetes does not occur if pancreatic substance is transplanted somewhere under the skin.

In 1898, Carl von Noorden published the second edition of "Diabetes and its Treatment".

First half of the 20th century

In 1900 Leonid Sobolew (1876–1919) recognized the "islands" as production sites for blood sugar-lowering substances.

In 1902, Carl von Noorden developed a diet oat cure that lowers blood sugar levels.

In 1903, the German internist Georg Ludwig Zülzer (1870–1949) developed a therapeutic pancreas extract that could lower blood sugar and was the first approach to treating diabetes mellitus. However, because of serious side effects that were possibly allergic in nature, the preparation known as “Zülzer extract” could not be used in humans.

In 1909 the Belgian Jean de Meyer suggested the name "insulin", derived from the Latin "insula" for the still unknown substance.

In 1910 the English physiologist Edward Albert Sharpey-Schafer called the substance from the pancreas missing in diabetics “insulin”. It is not clear from the available sources who coined the name first.

In 1916, Nicolae Paulescu succeeded for the first time in obtaining insulin from pancreatic tissue. He named the preparation Pankrein, it was effective on a diabetic dog.

In 1921 Paulescu published his findings,

In 1922 he patented the manufacturing process for Pankrein in Romania.

In 1921 Frederick Banting and Charles Best also succeeded in extracting insulin, which they called Isletin. They also carried out their experiments on dogs whose pancreas had been surgically removed. They confirmed the work of Paulescu in their publications. Previous attempts by other scientists had not been successful because, by using the whole ground pancreas, other digestive juices of the pancreas destroyed the insulin. The biochemist James Collip was hired by John James Richard Macleod to support Banting and Best. Collip succeeded in obtaining a much purer extract by means of fractionated protein precipitation with high-percentage alcohol.

In 1922, the team led by Banting and Best succeeded in saving a diabetic for the first time. 13-year-old Leonard Thompson, who had had the disease for a year and a half, was treated with beef insulin by them at Toronto General Hospital. After just three days, his urine was free of sugar and acetone. Banting, Best, Collip, Campbell, and Fletcher reported on it in the Canadian Medical Association Journal. Thompson survived for 14 years until he died of pneumonia unrelated to his diabetes. Theodore Ryder, who was treated in July 1922, was five years old at the time, and even survived for 70 years and thus achieved what is probably the longest documented survival time of a diabetes patient in medical history.

In 1922 the Senate of the University of Toronto founded a committee to control the industrial production of insulin using the patented process. First, a contract was signed with the Lilly company.

In 1923 Banting and MacLeod received the Nobel Prize in Medicine "for the discovery of insulin"; they later voluntarily shared the award with Best and Collip. That same year, Eli Lilly and Company, who worked with Banting and Best, launched the first insulin supplement, "Iletin," in Toronto.

Insulin production began in Europe in 1923. On October 31, Farbwerke Hoechst presented the “Insulin Hoechst” made from calf and cattle pancreas. Further production facilities were set up in Denmark (Hagedorn) and Austria.

In the decades that followed, insulin was extracted from the pancreas of cattle and pigs. Although animal insulin is also effective in humans, attempts have nevertheless been made to produce human insulin, since treatment with unmodified animal insulin often led to serious immunological side reactions.

In 1926 John Jacob Abel (1857–1938) at the Johns Hopkins University in Baltimore succeeded in producing insulin in a pure, crystalline form.

In 1928, Oskar Wintersteiner (1898–1971) succeeded in proving that insulin is a protein.

In 1930 Gerhardt Katsch opened the first diabetic home in Europe in Garz on Rügen, where patients were cared for and trained in how to deal with the disease.

In 1932 Dorothy Crowfoot Hodgkin began chemical analysis of insulin in Oxford. It would take 35 years to decipher the entire structure.

In 1934 A. Scott developed the first zinc insulin after he had shown that insulin contained zinc and that it was thereby slowed down in its effectiveness.

In 1936 Hans Christian Hagedorn developed the long-acting insulin preparation Neutral Protamine Hagedorn (NPH insulin).

In 1937 Gerhardt Katsch coined the term "conditionally healthy" for diabetics in his Garzer theses.

In 1939, Harold Percival Himsworth first described the differentiation of diabetes mellitus into different forms based on differences in insulin sensitivity.

In 1947 Gerhardt Katsch founded the second diabetic home in Karlsburg.

In 1947 Carl Ferdinand Cori and Gerty Cori received the Nobel Prize in Medicine “for their discovery of the course of the catalytic glycogen metabolism”. The Cori cycle is an important part of the sugar metabolism. The second part of the Nobel Prize for Medicine went to Bernardo Alberto Houssay "for his discovery of the importance of the hormones of the anterior pituitary gland for sugar metabolism".

In 1950 the International Diabetes Federation was founded.

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