In 1500 BCE, an Egyptian scribe wrote about a mysterious condition causing too great an emptying of the urine, unaware that the fluid was sweet to the touch. This observation marked the first known description of diabetes, a disease that would remain a medical enigma for millennia. The ancient Greeks later named the condition diabetes, meaning a passer through, to describe the excessive flow of urine. By the 2nd century CE, Aretaeus of Cappadocia provided the first detailed account, noting the disease's rapid progression and linking it to moisture and coldness, a belief that would dominate medical thought for centuries. It was not until 1675 that Thomas Willis added the word mellitus, meaning honey-sweet, after noticing the urine of affected individuals attracted ants. This sweet taste, caused by excess glucose spilling into the urine, became the defining characteristic of the disease, yet the underlying mechanism remained a complete mystery until the 20th century.
The Insulin Revolution
For centuries, a diagnosis of diabetes was effectively a death sentence, with patients wasting away to death from starvation or ketoacidosis. The turning point arrived in 1921 when Canadian researchers Frederick Banting and Charles Best isolated and purified insulin from the pancreas of dogs. Their breakthrough transformed the disease from a fatal condition into a manageable chronic illness, saving millions of lives. Before this discovery, the only treatment was extreme starvation diets designed to keep blood sugar levels low enough to prevent immediate death, but these diets often led to severe malnutrition and early mortality. The development of long-acting insulin, known as NPH, in the 1940s further revolutionized care, allowing for more stable blood sugar control. This medical miracle demonstrated that the body's inability to produce insulin was the root cause of Type 1 diabetes, an autoimmune condition where the immune system attacks the beta cells in the pancreas. The discovery of insulin remains one of the most significant achievements in medical history, shifting the narrative of diabetes from inevitable decline to a complex but manageable reality.The Silent Epidemic
Today, the number of people living with diabetes has surged from 200 million in 1990 to 828 million in 2024, making it one of the fastest-growing health crises in human history. More than half of those affected remain unaware of their condition, a silent epidemic that silently damages organs and blood vessels. Type 2 diabetes accounts for over 95% of all cases, driven by a combination of genetic susceptibility and lifestyle factors such as obesity, physical inactivity, and poor diet. The disease is no longer confined to wealthy nations; the greatest increase in rates is occurring in low- and middle-income countries, where more than 80% of diabetic deaths now take place. In these regions, rapid urbanization and the global nutrition transition, marked by the increased intake of energy-dense but nutrient-poor foods, have created a perfect storm for the disease. The economic burden is staggering, with global expenditure on diabetes-related healthcare estimated at US$760 billion a year, yet the human cost is far higher, with diabetes accounting for approximately two million deaths annually.