The History of Diabetes in the 20th and 21st Century
We’ve come a long way in the treatment of diabetes – from vials, diabetic pens to insulin pumps. Over the past ten years to fifteen years, there’s been more drug classes introduced to treat elevated blood glucose and tools to help manage your diabetes than ever before.
Below you'll learn how diabetes treatment has evolved since the 20th and 21st century.
The 20th Century
- 1910. Sir Edward Albert Sharpey-Schafer studies the pancreas and discovers insulin.
- 1921. Elliot Joslin (1870-1962) identifies obesity as being related to diabetes, and describes diabetes as an “epidemic.” Frederick Banting, MD, and Charles Best, MD, extract insulin from dog pancreases. After testing the insulin on other dogs, it is purified and tested on humans. The men go on to win the Nobel Peace Prize in 1923.
- 1923. Eli Lilly and Company begin to produce insulin commercially.
- The 1930s. A distinction is made between diabetes that required insulin and diabetes that can be treated without the use of insulin.
- 1940. The American Diabetes Association (ADA) is founded. The ADA was established to address the increasing incidence of diabetes and the complications it caused; it is still in existence today and still works at these causes. The ADA was established to address the increasing incidence of diabetes and the complications it caused; it is still in existence today and still works at these causes.
- 1949. Insulin metabolism is discovered. Insulin works like a “key” to unlock the “door” to the cell, allowing glucose to enter the cell so that the cell may transport it throughout the body for energy. Standardized insulin syringes are introduced.
- 1950. The terms “type 1” and “type 2” diabetes are proposed to differentiate the two types of diabetes but are not adopted until 1970. The “exchange system” is introduced by the American Dietetic Association and the US Public Health Service, and divides food into groups based on carbohydrates, fats, and protein.
- 1953. Urine blood glucose testing strips are introduced.
- 1959. A way to differentiate “insulin-dependent” and “non-insulin dependent” diabetes is introduced. A radioimmunoassay blood tests are available and detect insulin in the blood.
- 1961. Glucagon is now available to treat severe hypoglycemia; Eli Lilly and Company produce it.
- 1964. Blood glucose testing strips are introduced, and these testing strips are color coded.
- 1971. Insulin receptors are identified on cell membranes. Scientists discover that people with missing or defective insulin receptors may have type 2 diabetes.
- 1972. U100 insulin is introduced.
- 1976. The first insulin pump is invented.
- 1977. The glycosylated hemoglobin (A1C) is developed and becomes the gold standard for measuring long-term diabetes control.
- 1978. Although diabetes has since been differentiated as “insulin-dependent” and “non-insulin dependent,” it is not labeled as type 1, type 2, gestational, or diabetes associated with other syndromes or conditions.
- 1980. The term “diabesity” is introduced; according to Diapedia, “The subsequent epidemic of diabesity may be attributed to rising affluence in many parts of the globe, reduced physical activity, and increasing lifespan (type 2 diabetes favors the over-60s).”
- 1983. Second-generation sulfonylureas enter the market – meaning fewer side effects.
- 1989. The ADA releases its first Standards of Care.
- 1993. The Diabetes Control and Complications Trial (DCCT) shows that keeping blood glucose levels in control promotes the reduction of complications, such as retinopathy and nephropathy.
- The Mid-1990s. The incretin hormone GLP-1 is identified, leading to research on its effect on blood glucose control.
- 1995. Metformin is released to the public and becomes the gold standard for type 2 diabetes blood glucose control.
Diabetes in the 21st Century
- 2002. Prediabetes is defined as an A1C level of 5.7% to 6.4%.
- 2005. Byetta, the first GLP-1 receptor agonist in its class, is released.
- 2006. Januvia, the first DPP-4 inhibitor, is released.
- 2008. The ACCORD, ADVANCE, and VADT trials are completed. The trials showed failed to show that “a benefit of intensive glycemic control on cardiovascular outcomes in people with type 2 diabetes who are at high cardiovascular risk. The results from these studies lead to clinical recommendations that call for a more individualized approach for setting glycemic goals and treatment targets.”
- 2013. Invokana, the first SGLT-2 inhibitor, is released.
- 2017. The CANVAS Program, which studied Invokana’s effect on heart outcomes, found that the drug has positive cardiovascular outcomes and renal protective benefits. It's the first diabetes medication that is found to promote heart health, as opposed to being heart-neutral – which is a groundbreaking therapy. Further studies are being performed on the other SGLT-2 inhibitor medications. Medtronic introduces the 670G insulin pump – the world’s first hybrid closed-loop insulin pump. The pump uses continuous glucose monitoring (CGM) to detect fluctuations in blood glucose levels. The person wearing the pump must still enter carbohydrates and calibrate the pump, but the pump makes micro basal rate adjustments, acting like a pancreas.
The Bottom Line…
November is Diabetes Awareness Month, so if you are concerned that you may have diabetes, feel empowered to discuss your concerns with your physician.