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November is National Diabetes Month, dedicated to raising awareness and education about how diabetes affects the body and how it can be prevented. Prevention is the focus of National Diabetes Month 2024.1 Diabetes, which is characterized by high blood sugar levels, can often be prevented and managed with certain lifestyle changes and medications. Understanding risk factors for type 2 diabetes, such as age, weight, and race, may make at-risk people more likely to modify their lifestyles to avoid developing the disease.
Diabetes remains an epidemic in the United States. According to the Centers for Disease Control and Prevention, an estimated 38.4 million people in the United States had diabetes in 2021, representing 11.6% of the population.2 Of the 38.1 million Americans with diabetes who are 18 years of age or older, 8.7 million of them met the diagnostic criteria but were unaware or did not report their diabetes. .2
With more than 10% of the U.S. population estimated to have some form of diabetes, education about symptoms and prevention is as important as ever. What is the history of diabetes? When was National Diabetes Month first observed? What impact has it had on diabetes awareness since then?
Diabetes History and National Diabetes Month
Diabetes mellitus, also known as diabetes mellitus, has been described in the literature for centuries.3 Ancient Egyptian papyri described patients as suffering from excessive thirst and urination. However, the Egyptian endocrinologist Paul Gharioungi, who transcribed the Ebers Papyrus, considered the mention of possible diabetes to be inaccurate.
Other ancient cultures, including the Indian surgeon Sushruta, also noticed the symptoms of diabetes without naming them, but the symptoms of sweet, sticky urine were attributed to a disease caused by the diets of wealthy castes that included sweets. It was explained that it is part of.3 However, it was in ancient Greece that the term diabetes (meaning “to pass” in Greek) was first used by Apollonius of Memphis sometime between 250 and 300 BC.4 Aretaeus of Cappadocia is credited with popularizing the term diabetes and being the first to accurately describe the condition.3 Aretaeus described diabetes as a chronic disease with constant urination and burning thirst, passing through the kidneys and bladder.
Mellitus, which means “sweet” in Latin, was eventually incorporated into its name due to the sweet nature of diabetic urine. This happened in the 17th century when the English physician Thomas Willis wrote about the sweetness of the urine of diabetics. Sushruta had recorded it centuries ago.3 Dr. Willis attributed this to a combination of dietary habits and psychological sadness, while also noting the contractions and tingling that are common in diabetic neuropathy. He suggested that a diet of slimy vegetables, rice, and white starches could improve the patient's health. In the 18th century, another British doctor, Matthew Dobson, discovered the presence of sugar in urine.3
In the 19th century, great advances in the understanding of diabetes were made under the influence of French physiologist Claude Bernard, who caused controversy for his use of animal vivisection in his research.3 His research found that dogs fed more carbohydrates had larger amounts of glucose in their livers. He hypothesized that the liver stores a starchy substance called glycogen, which is converted to glucose and secreted into the blood, which is the cause of diabetes.3
Later that century, German physicians Oskar Minkowski and Josef von Mehring discovered the role the pancreas plays in glucose regulation.3 This was discovered when a dog that had no sugar in its urine before surgery developed diabetes after undergoing pancreatectomy. This was a particularly important advance because it led to the discovery of insulin, a lifesaver for diabetics.
discovery of insulin
The discovery that the pancreas plays a role in regulating sugar in the body led other researchers to wonder if something inside the pancreas could be extracted and administered by injection. In 1921, Frederick Banting, in collaboration with Charles Best, removed the pancreatic glands of dogs, froze and crushed them, and administered it to dogs whose pancreas had been removed.3 The dog's blood sugar levels dropped significantly within two hours. Colleagues John McLeod and James Collip helped refine the extraction process and named the extracted substance 'insulin'.
Insulin was first tested in humans in 1922, when it was given to a 14-year-old boy named Leonard Thompson living in Toronto.3 Thompson received two shots, and the second one was an overwhelming success. In just 24 hours, my blood sugar levels dropped from a dangerously high 520 mg/dL to 120 mg/dL. By 1923, Lilly Pharmaceutical Company collaborated with Banting and Best to produce the first commercially available insulin.
The discovery and availability of insulin was a huge boon for healthcare professionals and patients, and the following decades led to further research and the development of multiple insulin formulations. In 1955, Dr. Frederick Sanger and colleagues at the University of Cambridge focused on the primary structure of insulin: a 21-amino acid A chain and a 30-amino acid B chain, interconnected via disulfide bonds.5 The first insulin pump was invented in 1963, and in 1978, Lilly research scientists collaborated with Genentech scientists to use E. coli to produce recombinant human insulin. By 1982, Lilly commercialized human insulin made from recombinant DNA.5
When was the first National Diabetes Month?
The 1980s were a particularly exciting time for diabetes awareness and research, due in part to the availability of insulin made from recombinant DNA and home products that allowed patients to test and monitor their blood sugar levels.6 It was also in this decade that National Diabetes Month was first observed.
On September 29, 1981, the Reagan administration announced October 4-10 as National Diabetes Week.7 At the time, an estimated 10 million Americans had diabetes and more than 35,000 people died from diabetes each year. Just over a year later, on November 2, 1982, President Reagan proclaimed November as National Diabetes Month.8 With this declaration, the estimated number of Americans with diabetes increased to 11 million.
The importance of raising awareness about diabetes
Although awareness of diabetes has improved and multiple treatment options have become more readily available, diabetes remains a global epidemic. In 1980, 108 million people worldwide had diabetes. By 2014, that number was 422 million.9 According to a study published in lancetIn 2021, an estimated 529 million people worldwide will be living with diabetes.10 The same study predicts that by 2050, more than 1.31 billion people may have diabetes.
Much of the increase in diabetes prevalence is due to a worldwide increase in body mass index (BMI), which is thought to be due to limited access to health. health food in low-income and middle-income areas.10 Obesity is a significant risk factor for type 2 diabetes¹. This is why diabetes awareness is especially important. In 2021, 96% of diabetes cases worldwide were type 2 diabetes.10 Because a significant proportion of diabetes is potentially preventable, risk factors, blood sugar management, and lifestyle habits are important to help patients make informed decisions to optimize their health. It is essential to raise awareness of improvements.
