Diabetes

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HISTORY Man has long recognized diabetes mellitus, and this disorder – or a syndrome resembling it – was well known to the ancients. The original clinical description must now be lost in antiquity, but Lazarus and Volk in their excellent historical review attributed the earliest writings on this subject to the papyrus Ebers (circa 1500 B.C.). The term “diabetes” that we use today was introduced in more recent times by Aretaeus of Capdocia shortly after the birth of Christ. From this date onwards, the classical literature abounds with references to diabetes mellitus. However, the basic hormonal abnormalities remained unknown until the pioneering labors of Banting and Best resulted in the purification of insulin in 1921 (Robert M. Galbraith 1). The consequent realization that diabetes involves an absolute or relative deficiency of insulin can be considered to clarify the question of “what is the basic hormonal abnormality?”. However, the questions of “how?’ and “why?” remain to be resolved DEFINITION Diabetes mellitus, a chronic disease of unknown etiology, is characterized by a primary disturbance in the metabolism of carbohydrate and by the impaired utilization of protein and fats. Either an insufficiency or abnormality of insulin reaction apparently mediates the basic metabolic disturbance that occurs. The sugar, which cannot be properly utilized by the body, collects in the blood and may be subsequently excreted in the urine. In addition, a functional alteration of the vascular system, including both the large and small blood vessels, inevitably occurs (U.S. News and World Report 74) . DEFINITION OF TYPE 1 DIABETES Diabetes is usually classified as either growth onset diabetes (type 1 or juvenile) or adult diabetes (type2). Type 1 diabetes almost always appears explosively in persons under 20 years of age and is recognized because the patient becomes acutely ill. The juvenile diabetic’s condition is labile, and b...