Textbook of Diabetes

Richard I. G. Holt, Clive Cockram, Allan Flyvbjerg, Barry J. Goldstein, Richard I. G. Holt, Clive Cockram, Allan Flyvbjerg, Barry J. Goldstein

• Publisher: Wiley-Blackwell
• Year: 2016
• ISBN:
  9781118924860
• Edition: 5
• Topic: Medicine
• Subtopic: Endocrinology & Metabolism

Now in its fifth edition, the Textbook of Diabetes has established itself as the modern, well-illustrated, international guide to diabetes. Sensibly organized and easy to navigate, with exceptional illustrations, the Textbook hosts an unrivalled blend of clinical and scientific content. Highly-experienced editors from across the globeassemble an outstanding set of international contributors who provide insight on new developments in diabetes care and information on the latest treatment modalities used around the world. The fifth edition features an array of brand new chapters, on topics including:

• Ischaemic Heart Disease
• Glucagon in Islet Regulation
• Microbiome and Diabetes
• Diabetes and Non-Alcoholic Fatty Liver Disease
• Diabetes and Cancer
• End of Life Care in Diabetes

as well as a new section on Psychosocial aspects of diabetes.

In addition, all existing chapters are fully revised with the very latest developments, including the most recent guidelines from the ADA, EASD, DUK and NICE.

Includes free access to the Wiley Digital Edition providing search across the book, the full reference list with web links, illustrations and photographs, and post-publication updates

Via the companion website, readers can access a host of additional online materials such as:

• 200 interactive MCQ's to allow readers to self-assess their clinical knowledge
• every figure from the book, available to download into presentations
• fully searchable chapter pdfs

Once again, Textbook of Diabetes provides endocrinologists and diabetologists with a fresh, comprehensive and multi-media clinical resource to consult time and time again.

1
Diabetes in its Historical and Social Context

1
The History of Diabetes Mellitus

Robert B. Tattersall¹

University of Nottingham, Nottingham, UK

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Key points

• Polyuric diseases have been described for over 3500 years. The name “diabetes” comes from the Greek word for a syphon; the sweet taste of diabetic urine was recognized at the beginning of the first millennium, but the adjective “mellitus” (honeyed) was only added by Rollo in the late 18th century.
• The sugar in diabetic urine was identified as glucose by Chevreul in 1815. In the 1840s, Bernard showed that glucose was normally present in blood, and showed that it was stored in the liver (as glycogen) for secretion into the bloodstream during fasting.
• In 1889, Minkowski and von Mering reported that pancreatectomy caused severe diabetes in the dog. In 1893, Laguesse suggested that the pancreatic “islets” described by Langerhans in 1869 produced an internal secretion that regulated glucose metabolism.
• Insulin was discovered in 1921 by Banting, Best, Macleod, and Collip in acid-ethanol extracts of pancreas. It was first used for treatment in January 1922.
• Diabetes was subdivided on clinical grounds into diabète maigre (lean subjects) and diabète gras (obese) by Lancereaux in 1880, and during the 1930s by Falta and Himsworth into insulin-sensitive and insulin-insensitive types. These classifications were the forerunners of the etiological classification into type 1 (insulin-dependent) and type 2 (non-insulin-dependent) diabetes.
• Insulin resistance and β-cell failure, the fundamental defects of type 2 diabetes, have been investigated by many researchers. The “insulin clamp” method devised by Andres and DeFronzo was the first accurate technique for measuring insulin action. Maturity-onset diabetes of the young was described as a distinct variant of type 2 diabetes by Tattersall in 1974.
• Lymphocytic infiltration of the islets (insulitis) was described as early as 1901 and highlighted in 1965 by Gepts who suggested that it might be a marker of autoimmunity. Islet cell antibodies were discovered by Doniach and Bottazzo in 1979.
• The primary sequence of insulin was reported in 1955 by Sanger and the three-dimensional structure by Hodgkin in 1969. Proinsulin was discovered by Steiner in 1967, and the sequence of the human insulin gene by Bell in 1980. Yalow and Berson invented the radioimmunoassay for insulin in 1956. The presence of insulin receptors was deduced in 1971 by Freychet, and the receptor protein was isolated in 1972 by Cuatrecasas.
• The various types of diabetic retinopathy were described in the second half of the 19th century as were the symptoms of neuropathy. Albuminuria was noted as a common abnormality in people with diabetes in the 19th century and a unique type of kidney disease was described in 1936 by Kimmelstiel and Wilson. The concept of a specific diabetic angiopathy was developed by Lundbæk in the early 1950s.
• Milestones in insulin pharmacology have included the invention of delayed-action preparations in the 1930s and 1940s; synthetic human insulin in 1979; and in the 1990s novel insulin analogs by recombinant DNA technology.
• The first sulfonylurea carbutamide was introduced in 1955, followed by tolbutamide in 1957 and chlorpropamide in 1960. The biguanide phenformin became available in 1959 and metformin in 1960.
• That improved glucose control in both type 1 and type 2 diabetes was beneficial was proved by the Diabetes Control and Complications Trial (1993) and the UK Prospective Diabetes Study (1998).
• Landmarks in the treatment of complications include photocoagulation for retinopathy first described by Meyer-Schwickerath; the importance of blood pressure control to slow the progression of nephropathy (demonstrated by Mogensen and Parving); the introduction of low-dose insulin in the treatment of diabetic ketoacidosis in the 1970s; and improvements in the care of pregnant women with diabetes pioneered by White and Pedersen.

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Ancient times

Diseases with the cardinal features of diabetes mellitus were recognized in antiquity (Table 1.1). A polyuric state was described in an Egyptian papyrus dating from ca 1550 BC, discovered by Georg Ebers (Figure 1.1), and a clearly recognizable description of what would now be called type 1 diabetes was given by Aretaeus of Cappadocia in the 2nd century AD (Figure 1.2a). Aretaeus was the first to use the term “diabetes,” from the Greek word for a syphon, “because the fluid does not remain in the body, but uses the man's body as a channel whereby to leave it.” His graphic account of the disease highlighted the incessant flow of urine, unquenchable thirst, the “melting down of the flesh and limbs into urine” and short survival.

Table 1.1 Milestones in the clinical descriptions of diabetes and its complications.

Clinical features of diabetes
Ebers papyrus (Egypt, 1500 BC)	Polyuric state
Sushrut and Charak (India, 5th century BC)	Sugary urine; thin and obese patients distinguished
Aretaeus (Cappadocia, 2nd century AD)	Polyuric state named “diabetes”
Chen Chuan (China, 7th century)	Sugary urine
Avicenna (Arabia, 10th century AD)	Sugary urine; gangrene and impotence as complications
Diabetic ketoacidosis
William Prout (England, 1810–1820)	Diabetic coma
Adolf Kussmaul (Germany, 1874)	Ac...