During the Renaissance, doctors began laboriously rediscovering some of the ancient knowledge. The sixteenth-century Swiss physician Paracelsus, for example, found a white powder when he evaporated the urine of a person with diabetes, but mistakenly thought it was salt. In 1683 another Swiss physician, Johann Conrad Brunner, removed the pancreases of dogs and found that they suffered from great thirst and excessive urination, but he did not realize that he had created an experimental model of diabetes.
In 1766 an English physician, Matthew Dobson, made the first new breakthrough. He proved chemically that the sweetness of the urine was due to the presence of sugar. He also found sugar in the blood of both healthy people and those with diabetes, and he suggested that the sugar in the urine of people with diabetes came from their blood.
Doctors had to taste their patients’ urine to determine whether sugar was present until the early nineteenth century, when German physician Johann Frank invented a yeast test for sugar. Around this time, doctors such as British physician John Rollo were experimenting with low-carbohydrate diets in the treatment of diabetes, and during the 1800s a high fat intake, green vegetables, and exercise typically were prescribed. Such treatments sometimes helped people with diabetes get better—especially if they were obese older people. But there was little that doctors could do for children with diabetes, and they usually had only a few months to live.
The doctors did not know what caused diabetes. Eighteenth-century English physician Thomas Cawley, who was the first to diagnose diabetes on the basis of sugar in the urine, had thought it was a kidney disease.
In 1889 European medical researchers Joseph von Mering and Oskar Minkowski were trying to prove that the pancreas is involved in the digestion of fats. They removed the pancreas of a dog to see what would happen. After the operation the dog began to urinate uncontrollably, as Brunner’s dogs had more than two hundred years earlier. Von Mering and Minkowski found that the dog’s urine contained sugar; it had developed diabetes. Unlike Brunner, they concluded that diabetes was a disease of the pancreas. But the pancreas is a digestive gland, producing substances to help break down food. What could it have to do with diabetes?
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Archive for the ‘Diabetes’ Category
The G.I. factor is important in heart disease too. It has a role in the diets of people who already have heart disease, but perhaps of greater significance in the long term, it has a practical role in the prevention of heart disease.
Preventing heart disease: primary prevention. More and more people now get regular checks of their blood pressure, and tests to check for diabetes. Increasingly blood fat tests are done to check this risk factor too. All health professionals give lifestyle advice on stopping smoking, the benefits of exercise and the nature of a good diet. When specific risk factors are discovered, diet and lifestyle advice is given, but sometimes may not be followed for long. It is especially difficult to follow advice if the effect of not following it is likely not to matter for ten or more years, and if the changes needed are not attractive. The changes must be wanted by the individual who will be helped by encouragement from friends and relatives, and the changes must ideally be positive changes—’I want to do this’ not ‘They’ve told me to do this’. Any new dimension in heart disease prevention must be seen as a great positive change rather than as negative.
Treating heart disease and secondary prevention. When heart disease is detected two types of treatment are given. Firstly the effects of the disease are treated (e.g. medical treatment with drugs and surgical treatment to bypass blocked arteries) and, secondly, the risk factors are treated to slow down the further progression of the disease. Treatment of risk factors after the disease has already developed is ‘secondary prevention’. In people who have not yet developed the disease, treatment of risk factors is ‘primary prevention’. Obviously it would be better to give primary preventive treatment in all cases.
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