Diabetes Research Timeline

Diabetes was first described in 1500 BCE in an Egyptian manuscript that referred to a “too great emptying of urine.”

Type 1 diabetes and type 2 diabetes were first described as separate disorders by Indian doctors in 400-500 CE, with one type associated with youth and the other with obesity.

In the 17th century, doctors diagnosed diabetes by tasting the urine. If it was sweet, the diagnosis was Diabetes Mellitus, or “honeyed urine.”

To report on 3,500 years of treatment and research would take more space than is available here, so we will have to settle for a few highlights.

Insulin Developments

In 1910, English physiologist Sir Edward Albert Sharpey-Shafer, who was studying the pancreas, discovered that a substance he named insulin was not produced by diabetics.

The first use of insulin as a treatment was in 1921, when two Canadian doctors successfully treated a dog suffering from canine diabetes.

A few months later, a 14-year-old boy gravely ill with diabetes was successfully treated with insulin derived from cows. Within 24 hours, his sugar levels went from dangerously high to near normal levels.

The success of this treatment was so dramatic that Eli Lilly, in conjunction with the University of Toronto, began manufacturing bovine-sourced insulin commercially in 1923.

In 1936, Novo Nordisk began manufacture of a slower-acting form of insulin known as protamine insulin.

The production of U100 insulin began in 1972. The combination of this consistent concentration with syringes marked with a U100 scale was instrumental in reducing dosing errors.

It wasn’t until 1980 that biosynthetic insulin, created by genetically altered bacteria, was introduced by the U.S. Biotech firm Genentech, replacing bovine insulin.

In 1996, Lispro was introduced by Eli Lilly under the name Humalog. It was marketed as the world’s “fastest acting insulin.”

Advances in Therapeutic and Preventive Drug Treatments

In 1953, sulfonylureas were introduced. These oral medications stimulate the pancreas to produce more insulin. Second generation versions of this drug were first released in 1983, allowing patients to take smaller doses and causing fewer side effects.

1961 saw the release of glucagon by Eli Lilly. Glucagon is used as a treatment for severe hypoglycemia.

Metformin became available in the U.S. in 1995, many years after becoming available in the UK (in 1958) and Canada (in 1972). This drug works by suppressing glucose production in the liver. It is the largest selling antidiabetic drug worldwide and one of only two oral antidiabetics on the World Health Organization Model List of Essential Medicines.

Acarbose (brand name: Precose) became available in the U.S. in 1996. This drug slows digestion of some carbohydrates.

In 1997, Rezulin, a product of Parke-Davis, was approved for use. It was the first drug of its kind, used to improve insulin sensitivity in muscle cells. It was later withdrawn from the market when reports of liver toxicity began to circulate. Other drugs in this class are still available for use.

1998 saw the release of Prandin, a product of Parke-Davis. It was a member of a class of drugs that stimulate insulin production in the presence of glucose.

Byetta is an injectable drug that also works to increase insulin production in response to increasing glucose levels. It was introduced in 2005.

Also in 2005, Symlin was approved for use as an injectable adjunct to insulin for those who failed to achieve blood glucose goals.

Januvia, the first of a new class of drugs designed to enhance the body’s ability to lower blood glucose levels, was approved by the FDA in 2006.

In 2013, the FDA approved Invokana. This drug, one of a new class of drugs, works to reduce glucose re-uptake and increase secretion of glucose through the kidneys and out of the body via urine.

Advances in Measuring Diabetes

In 1953, tablets became widely available for the testing of urine glucose levels. Over the next few years, urine test strips became available. In 1964, color-coded test strips became available.

The first glucose meter was introduced in 1970.

In 1977, researchers in Boston develop the A1C test, currently the most commonly used test for measuring glucose control over a period of months.

In 2002, the American Diabetes Association released definitions of prediabetes as impaired fasting glucose (IFT) of 100-125 mg/dl or impaired glucose tolerance (IGT) of 140-199 mg/dl two hours after consuming a glucose-rich drink. This was later amended to include A1C levels of 5.7 to 6.4 percent.

Sources: DiabetesHealth.com and ADA

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