Changing Concepts of the Cause of Diabetes Mellitus

Abstract

Probably the first allusion to diabetes is contained in the papyrus Ebers, dated at about 1500 B .C . and the symptomatology of the disorder was described by Aretaeus in the 1^st century A.D. Prior to the late 17th century the causation of diabetes was variously ascribed to excessive food, alcohol, sex or grief or to maladies of the stomach, arteries, blood, nervous and other systems. However, in 1683 the Swiss Brunner recorded that pancreatectomised dogs displayed great thirst and polyuria before dying in coma, and in 1788 Cawley reported destruction of the pancreatic tissue in a patient dying of diabetes. These observations were largely disregarded until further evidence of a possible relationship between diabetes and the pancreas was provided by the classical experiments of von Mering and Minkowski in 1890. Twenty years earlier Langerhans, when aged 20, had described the islets to which his name was given in 1893 by Laguesse who was the first to suggest that they might produce an internal secretion. Schafer in 1895 considered that this secretion might profoundly modify the carbohydrate metabolism of the tissues and the name “ insuline” was proposed by de Meyer in 1909.