Diabetes mellitus is a heterogeneous group of diseases characterized by chronic elevation of glucose in the blood. It arises because the body is unable to produce enough insulin for its own needs, either because of impaired insulin secretion, impaired insulin action, or both. Diabetes affects some 300 million people world-wide, and is on the increase. Chronic exposure to high blood glucose is a leading cause of renal failure, visual loss and range of other types of tissue damage. Diabetes also predisposes to arterial disease, not least because it is often accompanied by hypertension, lipid disorders and obesity. Many cases of diabetes and almost all of its unwanted long-term consequences are potentially avoidable, but this will require intervention at a societal as well as at a medical level.
History Of Diabetes
Diabetes was considered a disease of the wealthy in ancient India, and was known as Madhumeha (sweet urine disease); it was observed that ants were attracted to the urine. The ancient Greeks coined the term "diabetes", meaning excessive urination with dehydration, but they not the Romans appreciated that the urine contained sugar, "diabetes" was considered a kidney disease until the 18th century.
The sweet of the urine was known to Avicenna and to Thomas Willis in the 17th century. The sweet taste was known to be due glucose by the start of the 19th century, and raised glucose in the blood was recognize soon afterwards. The modern era was heralded by the discovery of Oskar Minkowski that removal of the pancreas result in diabetes, followed by the discovery of insulin in 1921-22.
The herbalist of the Middle Ages alredy knew the beneficial effect of the herb Galega officinalis, which ultimately led to the discovery of Metformin. Likewise, Claude Bernanrd alredy suspected that the brain was somehow involved in the causation of diabetes, a topic that continues to attract research attention today. These examples show that many people have made the same observation and considered the same hypotheses at widely differing times, and taht valuable findings are somtimes obscured by the fogs of time.
The societal strains and the intrinsic chronic burden of the disease make diabetes a disease with serious psychological side effects. There is a strong association between diabetes, reduced quality of life and depression. Supporting patients throughout the course of their disease and empowering them to take control of their lives is a major challenge to care-givers.