What Is Diabetes?
The term diabetes describes a metabolic disorder of multiple aetiology characterized by chronic hyperglycaemia with disturbances of carbohydrate, fat and protein metabolism resulting from defects in insulin secretion, insulin action, or both. The effects of diabetes include long– term damage, dysfunction and failure of various organs. Diabetes may present with characteristic symptoms such as thirst, polyuria, blurring of vision, and weight loss. In its most severe forms, ketoacidosis or a non–ketotic hyperosmolar state may develop and lead to stupor, coma and, in absence of effective treatment, death (Kitabchi, 2009). Often symptoms are not severe, or may be absent, and consequently hyperglycaemia sufficient to cause pathological and functional changes may be present for a long time before the diagnosis is made (Hu et al.,2012). The long–term effects of diabetes mellitusinclude progressive development of the specific complications of retinopathy with potential blindness, nephropathy that may lead to renal failure, and/or neuropathy with risk of foot ulcers, amputation, Charcot joints, and features of autonomic dysfunction, including sexual dysfunction. People with diabetes are at increased risk of cardiovascular, peripheral vascular and cerebrovascular disease (American Diabetes Association, 2013).
History
Diabetes was one of the first diseases described with an Egyptian manuscript from on 1500 BCE mentioning "too great emptying of the urine".The first described cases are believed to be of type 1 diabetes Indian physicians around the same time identified the disease and classified it as madhumeha or "honey urine", noting the urine would attract ants (Kitabchi, 2009). The term "diabetes" or "to pass through" was first used in 230 BCE by the Greek Appollonius of Memphis (Lambert,2002).The disease was considered rare during the time of the Roman empire, with Galen commenting he had only seen two cases during his career. (Lee et al.,2012). This is possibly due the diet and life-style of the ancient people, or because the clinical symptoms were observed during the advanced stage of the disease. Galen named the disease "diarrhea of the urine" (diarrhea urinosa) (Verrotti et al., 2012). The earliest surviving work with a detailed reference to diabetes is that of Aretaeus of Cappadocia (2nd or early 3rd century CE). He described the symptoms and the course of the disease, which he attributed to the moisture and coldness, reflecting the beliefs of the "Pneumatic School". He hypothesized a correlation of diabetes with other diseases and he discussed differential diagnosis from the snakebite which also provokes excessive thirst. His work remained unknown in the West until the middle of the 16th century when, in 1552, the first Latin edition was published in Venice. (Lambert,2002). Type 1 and type 2 diabetes were identified as separate conditions for the first time by the Indian physicians Sushruta and Charaka in 400-500 CE with type 1 associated with youth and type 2 with being overweight. The term "mellitus" or "from honey" was added by the Briton John Rolle in the late 1700s to separate the condition from diabetes insipidus, which is also associated with frequent urination (Risérus, 2009). Effective treatment was not developed until the early part of the 20th century, when Canadians Frederick Banting and Charles Herbert Best isolated and purified insulin in 1921 and 1922.This was followed by the development of the long-acting insulin NPH in the 1940s(Lee et al.,2012)
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