Your Paleo Practitioner

Diabetes in Human History           

 Diabetes has become a major health epidemic around the world, accelerating in numbers in recent years. Data from 2015now states that half the U.S. population has diabetes or prediabetes. This is the result of the most recent estimated prevalence of diabetes in the 2011-2012 years, which has reached 12% to 14% among U.S. adults. There is a higher prevalence among non-Hispanic black, non-Hispanic Asian and Hispanic individuals.

Cases of diagnosed diabetes in the United States have increased from 5.6 million persons in 1980 to 20.9 million in 2011. The most recent numbers from 2012, according to the Centers for Disease Control (CDC) estimates that 29 million people in the United States (over 1 in 10 Americans) now have diabetes. Unfortunately, these numbers have continued to climb for decades and are expected to reach a staggering 1 in 3 Americans by 2050. As of the most recent numbers from 2012, an additional 86 million Americans over age 20 have prediabetes. This is up from only 79 million in 2010. The scariest thing about prediabetes is that it is estimated that less than 8% of those affected know about it! That means that either people don’t have regular blood work screening or their medical doctors don’t believe it warrants to be disclosed. Unfortunately in my clinical experience, it is too often the latter.

The earliest descriptions of the symptoms of diabetes were in the ancient physician records of Greek and Egyptian writings. Ancient Egypt was the first civilization to have a study of medicine and to have a written record. In an ancient document written in 1550 B.C. representing writings from two centuries prior circa 3500 B.C., there are the first references to diabetes mellitus. The frequent urination was mentioned with some suggested remedies; in fact, the word diabetes actually means “siphon”, via Latin in Greek. As Egyptian physicians were desperately trying to diagnose and treat diabetes, Hippocrates was first to connect diet to the development of diabetes. One of his students, Aretaeus, was the first to use the term diabetes when he described the frequent urination as a “meltdown of the flesh”. He was likely observing a late manifestation of undiagnosed and untreated diabetes where to body actually starves despite eating plenty of food. Diabetes was unable to be treated and was uniformly fatal within weeks to months after diagnosis.

It wasn’t until the late 1600’s through the 1700’s that experiments led to the conclusive diagnosis of diabetes from the presence of sugar in the urine and the blood. In 1769, William Cullen published a formal classification of human diseases. It was Cullen who added the word “mellitus” from the Latin word for ”honey”, to differentiate diabetes mellitus from diabetes insipidus, a disease of overproduction of antidiuretic hormone from the pituitary gland, which also causes a lot of water drinking and urinating, but no sugar in the urine.

The work of Paul Langerhan, during his research for his doctoral dissertation in 1869, discovered that the cells producing insulin were in the pancreas. These cells, now known as the “Islets of Langerhans” were unknown to play such a key role in diabetes research at this time, as insulin was yet to be discovered. With the experiments in 1889 by Mering and Minkowski found that removing the pancreas from a dog resulted in immediate and complete diabetes. This is when the role of this organ in diabetes became so understood. The hormone insulin was identified in 1910 by Edward Albert Sharpey-Schafer. He called it insulin, from the Latin word insula, meaning island and referring to the pancreatic beta cells of Langerhans.

The discovery of insulin in 1921 by doctors Frederick Banting and Charles Herbert Best really changed the future for diabetes research and all the lives it affected. Since 1923 there have been 10 scientists that have received the Nobel Prize for diabetes related studies.  In 1926, John Abel purified insulin, which led to the future of protein chemistry. Insulin is a protein and was first obtained from the pancreases of pigs for human use. For many years, pork and beef insulin were harvested and used to control blood glucose in those with diabetes.  Frederick Sanger won the Nobel Prize in 1958 for his work with the structures of proteins, specifically insulin proteins. This led to the first human insulins, which became available in the early 1980’s developed through recombinant DNA technology. This means that these newest insulins, still in use today, lack the impurities of insulin from other species, making them almost seamlessly tolerated.

Genetic factors do play a part in the development of any form of diabetes, however there are multiple genes involved. Environmental factors continue to have a huge influence over the development of the disease. Despite what many people believe, a predominant genetic susceptibility for type 2 diabetes has not really been found. There are many genetic factors that may influence and increase the likelihood of developing type 2 diabetes however it really only accounts for about 10% of risk. Type 2 diabetes is really a disease of lifestyle choices and is highly influenced by preventative and therapeutic strategies. Reducing blood sugar fluctuations throughout the day with a low glycemic index carbohydrate diet with higher percentages of protein and healthy fat has been shown to be an excellent way to reduce type 2 diabetes risk.

            Studies of the use of the Paleo diet have consistently produced the least glucose variability throughout the day in those with all kinds of diabetes as well as prediabetes. This high healthy fat and protein and low glycemic index carbohydrate diet is a favorite for those with and without diabetes for improved health. There is no doubt that a diagnosis of diabetes will certainly complicate a person’s life. It is now understood that type 2 diabetes will reduce the number of disability-free years among adults. Therefore, it is so vitally important that prediabetes be acknowledged as the disease that it is.