Avicenna, the famous Persian physician

Before Christ Mentionings

1500 BC

According to Egyptian Ebers’s parchment, dated 1552 B.C.,Hesy-Ra, an Egyptian physician documented frequent urination as a symptom of a mysterious disease that also caused emaciation.

600 BC

Sushruta (ancient indian surgeon) identified diabetes and classified it as Medhumeha literally meaning “sweet urine disease”. He further identified it with obesity and sedentary lifestyle, advising exercises to help “cure” it. The ancient Indians tested for diabetes by observing whether ants were attracted to a person’s urine. The Chinese, Japanese and Korean words for diabetes are based on the same ideographs which mean “sugar urine disease”.

First Century AD

In 150 AD, the Greek physician Aretaeus of Cappadocia, described what we now call diabetes as “the melting down of flesh and limbs into urine.”

Origins of the word Diabetes

It was derived from the Greek dia (across, apart) + bainein (to walk, stand) = diabaínein (to stride, walk, or stand with legs asunder) → diabētēs (one that straddles, a compass, siphon).

10th Century AD

Avicenna provided a detailed account on diabetes mellitus in The Canon of Medicine, “describing the abnormal appetite and the collapse of sexual functions,” and he documented the sweet taste of diabetic urine. Avicenna recognized a primary and secondary diabetes. He also described diabetic gangrene, and treated diabetes using a mixture of lupine, trigonella (fenugreek), and zedoary seed, which produces a considerable reduction in the excretion of sugar, a treatment which is still prescribed in modern times. Avicenna also described diabetes insipidus very precisely for the first time.

Middle Ages

1425

Diabetes first appears in the English language as the Middle English word ‘diabete’.

Renaissance

16th Century

Swiss physician Phillipus Aureolus Paracelsus – considered the ‘Martin Luther of Medicine’ – identifies diabetes as a serious general disorder.

1674

In his treatise Pharmaceutice rationalis, Professor Thomas Willis of Oxford University describes the ‘wonderfully sweet’ flavour of urine in diabetes mellitus.

Early Modern Era

1776

English physician Matthew Dobson of Liverpool evaporates two quarts of urine from a patient with diabetes. The resulting residue is granulated and smells and tastes like sugar, conclusively establishing the presence of ‘saccharine materials’ as a diagnosis of diabetes.

1797

Scottish physician John Rollo creates the first medical therapy to treat diabetes. He prescribes an ‘animal diet’ for his patients of ‘plain blood puddings’ and ‘fat and rancid meat’ so to manage the disease with foods their bodies could assimilate.

Modern Era

1869

German medical student Paul Langerhans discovers the islet cells of the pancreas but is unable to explain their function. The find is dubbed the ‘islets of Langerhans.

1871

French physician Apollinaire Bouchardat notices the disappearance of glycosuria in his diabetes patients during food rationing of food under the Siege of Paris in the Franco-Prussian War, and formulates individualized diets to treat the condition.

1889

Scientists Oskar Minkowski and Joseph von Mering of the University of Strasbourg, France demonstrate how removing a dog’s pancreas produces diabetes.

1891

On Nov. 14, 1891, Frederick Banting is born on his parents’ farm near Alliston, Ontario, north of Toronto.

1899

On Feb. 28, 1899, Charles Best born in West Pembroke, Maine.

1901

American pathologist Eugene Opie of John Hopkins University in Baltimore establishes a connection between the failure of the islets of Langerhans in the pancreas and the occurrence of diabetes.

1913

Prof. John J.R. Macleod writes a monograph on diabetes entitled ‘Diabetes: Its Pathological Physiology.

1916

On Dec. 1916, Boston pathologist Elliott Joslin compiles 1,000 of his own cases and creates the textbook The Treatment of Diabetes Mellitus. In it he reports that ‘the mortality of patients was approximately 20 per cent lower than for the previous year’, due to ‘the introduction of fasting and the emphasis on regular exercise.’ This book and Joslin’s subsequent research over the next five decades establishes his reputation as one of the world’s leading expert in diabetes.

1919

Dr. Frederick Allen of the Rockefeller Institute in New York publishes his Total Dietary Regulations in the Treatment of Diabetes that introduces a therapy of strict dieting – dubbed the ‘starvation treatment’ –- as a way to manage diabetes

1920

  • On July 1, 1920, Banting opens his first medical practice in London, Ontario.
  • On Oct. 31, 1920, Banting conceives of the idea of insulin after reading an article in the journal Surgery, Gynecology and Obstetrics by Moses Barron, an American pathologist, titled ‘The Relation of Islets of Langerhans to Diabetes with Special Reference to Cases of Pancreatic Lithiasis.’ He moves to Toronto and over the next year, with the support of Prof.. Macleod of the University of Toronto, and the assistance of Best, a medical student, and Dr. James Collip, continues his research using a variety of different extracts on depancreatized dogs.

1921

  • Banting’s work leads to the discovery of insulin. On July 30, 1921, Dog 410 is the first to receive the extract. On August 4 the extract is called ‘Isletin’ for the first time.
  • On Nov. 14, 1921, Dr. Banting and Charles Best deliver a preliminary report of their research to the Journal Club of the University of Toronto, Department of Physiology.
  • On Nov. 17, 1921, Banting and Best discover that extract from cattle foetal pancreas lowers blood sugar levels of depancreatized dogs, leading them toward plentiful, cheap sources for insulin. Experiments begin to test the long-term effectiveness of insulin treatment.
  • On December 1921, Dr. James Bertram Collip, a biochemist on sabbatical from the University of Alberta, joins the Banting and Best team to assist in refining the quality of extracts.
  • On Dec. 30, 1921, Banting, Macleod, Best and Collip present the results of their research at a session of the American Physiological Society at Yale University. The paper initially generates little interest. The paper – ‘The Internal Secretion of the Pancreas’ – is published two months later in the prestigious Journal of Laboratory and Clinical Medicine.

1922

  • In January 1922, Leonard Thompson, 14, a ‘charity patient’ at the Toronto General Hospital, becomes the first person to receive and injection of insulin to treat diabetes. Thompson lives another 13 years before dying of pneumonia at age 27.
  • On May 3, 1922, The word ‘insulin’ is used in public for the first time when Macleod presents the paper ‘The Effect Produced on Diabetes by the Extracts of Pancreas’ to the Association of American Physicians annual meeting in Washington, D.C. The results of the Toronto group’s experiments is hailed as ‘one of the greatest achievements of modern medicine’.
  • On May 30, 1922, Pharmaceutical manufacturer Eli Lilly & Co. of Indianapolis and the University of Toronto enter a deal for the mass production of insulin.
  • On Aug. 16, 1922, Elizabeth Evans Hughes, 13, daughter of U.S. Secretary of State Charles Evans Hughes, arrives in Toronto to be treated by Banting for her diabetes. Weighing only 45 pounds and barely able to walk, Elizabeth responds immediately to the insulin treatment, and goes on to live a productive life. She dies in 1981 at age 73.

1923

  • On Oct. 25, 1923, Banting and Macleod are awarded the Nobel Prize in Physiology or Medicine. Banting shares his award with Best, while Macleod shares his with Collip.
  • In October 1923, Insulin is made commercially available in the United States and Canada.

1936

  • In a series of research papers, Sir Harold Himsworth of the University College Hospital in London finds that diabetes falls into two types based on ‘insulin insensitivity.’ This discovery later leads to the diabetes classifications of type 1 and type 2.
  • Hans Christian Hagedorn, founder of Novo Nordisk, discovers that adding protamine to insulin prolongs the duration of action of the medication.

1941

  • On Feb. 21, 1941, At the height of the Second World War, Major Banting is killed in an airplane crash over Newfoundland while on a secret mission to England.

1944

The standard insulin syringe is introduced so to make diabetes management more uniform.

1949

Best co-founds the Diabetic Association of Ontario.

1959

Researchers identify type 1 diabetes (insulin dependent) and type 2 diabetes (non-insulin dependent).

1966

First pancreas transplant performed at the University of Manitoba

1971

  • On Sept. 14, 1971, Anton Hubert Clemens receives the first patent for a portable blood glucose meter called the Ames Reflectance Meter. Dr. Richard K. Bernstein, an insulin dependent physician with diabetes, uses the meter to monitor his blood glucose at home, and subsequently publishes a report on his experiences.

1982

Using recombinant DNA technology, pharmaceutical firm Eli Lilly develops the first biosynthetic human insulin – Humulin – that is identical in chemical structure to human insulin and can be mass produced.

1989

  • On July 7, 1989, Her Majesty Queen Elizabeth The Queen Mother kindles the Flame of Hope at Banting House National Historic Site – ‘The Birthplace of Insulin’ – in London, Ontario. As a symbol of hope, the flame will burn until a cure for diabetes is found.

1991

  • On November 5, 1991, As part of the 100th anniversary of Dr. Banting’s birth, a time capsule created by the International Diabetes Federation Youth Representatives is entombed by Governor General Ray Hnatyshyn at Banting House in London, Ontario. The capsule will be opened when a cure for diabetes is found.

1993

After 10 years of clinical study, the Diabetes Control and Complications Trial (DCCT) report is published and clearly demonstrates that intensive therapy delays the onset and progression of long-term complications in individuals with type 1 diabetes.

1995

Canadian Diabetes Association launches its website which quickly becomes a source of diabetes-related information for people all over the world.

1996

75th Anniversary of the discovery of insulin is celebrated around the world.

1998

The United Kingdom Prospective Diabetes Study (UKPDS) scientifically inks the control of glucose levels and blood pressure control to the delay and possible prevention of type 2 diabetes.

1999

Scientists conduct the first successful islet transplant at the University of Alberta Hospital. The surgical procedure becomes known as The Edmonton Protocol.

21st Century

2006

  • On Dec. 20, 2006, The United Nations recognizes diabetes as a global threat and designates World Diabetes Day, November 14 – in honour of Frederick Banting’s birthday – as a UN Day to be observed every year starting in 2007.