History of Diabetes Mellitus and Diabetes Insipidus
Diabetes mellitus also known as madhumeha was known to ancient Indian physicians many thousands of years ago. An elaborate description of its clinical features and its management is well described in Ayurveda. It is stated in Ayurveda that insects and flies were attracted to the urine of some people, which smelled sweet. Sushruta, an ancient sage diagnosed diabetes in 1000 B.C. Diabetes is a condition in which the body does not produce enough insulin or is unable to utilise the available insulin for converting the food into energy. Diabetes word is derived from the Greek words, diabainess means to pass through and the latin mellitus means sweetened with honey.
Our body derives most of the energy from the sugars, starches and other foods. Insulin is responsible for converting these chemicals into energy. Insulin is a hormone secreted by the pancreas, which is located near the stomach. When there is inactive insulin, the sugar levels increase in the blood stream, a condition called as hyperglycemia and spills into the urine, glycosurea. As there is lack of sugar, the other tissues starve. Microscopic blood vessels gets damaged slowly and leads to early cataract formation, even to blindness and kidney damage. Nerves get disrupted and causes pain and numbness in the extremities. Finally it may damage the heart also and leads to a syndrome. There are millions of people suffering from the diabetes worldwide, but because of the recent advances in medicine, people can lead a normal life with excellent quality of life. There are mainly 2 types of diabetes namely, Diabetes Insipidus and Diabetes Mellitus.
Diabetes insipidus:
It is an uncommon disorder in which excess urine is formed. It is due to the failure of the pituitary gland’s hormonal secretion and antidiuretic hormone. The primary defect may be in the pituitary gland itself or in the hypothalamus. Hypothalamus is the part of the brain floor which controls the secretion of the hormones. This defect can be corrected by giving the ADH by injection or snuff or nasal drops.
Diabetes mellitus:
Diabetes results due to the deficiency of the insulin. The deficiency may be caused due to many reasons, so diabetes is a group of diseases with similar symptoms, and not a single disease. Deficiency of insulin may occur when the pancreas does not secrete sufficient amount of insulin or when the person cannot utilise the insulin effectively, or if he requires more amount than what is secreted by the pancreas. If pancreas are removed from the person, there will be no secretion of insulin at all. In such instances, the person requires injections of about 20-30 units of insulin daily to stay healthy. The diabetic people form more amount of insulin than this and yet they require larger daily dose of insulin than the people with no pancreas. This is because they have antagonists to insulin in their tissues secreted by pancreas, most of the insulin may be wasted, their body cells (liver cells) do not respond to insulin. The exact nature of the antagonism of insulin is not known but it is opposed by the hormones of pituitary, adrenal, thyroid and glucagon of pancreas. Sometimes diabetes also may be due to the excess of these hormones. Diabetes is a symptom of cushing’s syndrome which is due to excess of adrenal hormones. In many cases antibiotics neutralise the insulin by combining with it or the liver may take the insulin and arrests them have the same symptoms. All these leads to the poor availability of the insulin.
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