Diabetes is a group of complex metabolic disorders. In diabetes there is complete or partial insufficiency of insulin secretion. There is also various degree of insulin resistance in diabetes mellitus. Diabetes is generally of two major types of diabetes, the type 1 - the insulin dependent diabetes mellitus (IDDM) and type 2 - non-insulin dependent diabetes mellitus (NIDDM).

Diabetes is a common non-communicable chronic disease which affects up to 5% to 10% of the adult population in the western world and it is becoming very common in developing countries too, such as India. The number of diabetes patients is increasing in India in such a way that within few decades India will be the Diabetes Capital, with largest number of diabetes patients in the world.

Some major landmarks in the history of diabetes:

• 1552 B.C. – Polyuria or frequent urination is a symptom of diabetes, described by Egyptian physician Hesy-Ra.
• In first century A.D.-Diabetes is described as “melting down of flesh and limbs into urine”.
• 11^th century A.D. – Mellitus is added to diabetes from Latin word “mellitus” means sweet smelling or honey as the urine of diabetic patient is sweet smelling.
• 16^th century A.D. – Paracelsus identifies diabetes as a major health problem.
• Early 1800s- The first test to detect sugar in urine by chemical analysis developed.
• 1869- German medical student Paul Langerhans discovers that pancreas contains 2 types of cells, one set of cells were named after him as the “islet of Langerhans” and the other set secrete pancreatic juice.
• 1870s- French physician Bouchardat formulates individualized diet for his diabetes patients, when he saw absence of sugar in urine of his diabetic patients during rationing of food in Paris, when siege by Germany during the Franco-Prussian war.
• 1889- Oskar Minkowski and Joseph von Mering from University of Strasbourg, France, studied the effects of absence of pancreas by removing pancreas from a dog.
• 1900-1915- Diabetic diets such as “oat cure”, rice diet, milk diet, use of opium etc. were tried.
• 1908- German scientist, George Zuelzer used injectable extracts of pancreas to treat glycosuria (presence of sugar in urine), but was unsuccessful, as it showed extreme side effects.
• 1910-1920- Frederick Madison Allen and Elliot P. Joslin, the two eminent diabetic experts of USA. In 1913 Frederick Madison Allen published “Studies Concerning Glycosuria and Diabetes”, a book which helped development of therapy for diabetes. Allen also published about the dietary regulation in management of diabetes and became director of diabetes research in Rockefeller institute. Allen also established first clinic for treatment of diabetes and hypertension, “The Physiactric Institute” in New Jersey, USA.
• 1920- Dr. Banting publishes “The relation of the Islet of Langerhans to Diabetes with special reference to Cases of Pancreatic Lithiasis” in the November issue of Surgery, Gynecology and Obstetrics in USA.
• 1921- Dr. Banting and Best discover insulin and treat a dog without pancreas (removed) successfully.
• 1940s- The long term complications of diabetes established. In 1944 the standard insulin syringe is discovered, making treatment of diabetes uniform.
• 1955- Oral hypoglycemic drugs are introduced to manage diabetes.
• 1959- The major types of diabetes the type 1 - the insulin dependent diabetes mellitus (IDDM) and type 2 - non-insulin dependent diabetes mellitus (NIDDM) identified.
• 1960s- Home test for glucose in urine developed and also purer form of insulin becomes available, making sugar control in diabetes better.
• 1970- Laser treatment used to slow or prevent blindness due to diabetic retinopathy. Blood glucose meters and insulin pumps are developed making management of diabetes better.
• 1983- First human insulin introduced.
• 1986- Insulin delivery by pen system introduced.
• 1993- Diabetes Control and Complication Trial (DCCT) clearly shows appropriate treatment of diabetes delays the onset of long term complications in individuals with type 1 diabetes.
• 1998- United Kingdom Prospective Diabetes Study (UKPDS) clearly shows good glucose control with appropriate therapy and good blood pressure control delay and/or prevention of complications (diabetic retinopathy, nephropathy, neuropathy etc.) of type 2 diabetes.