100 years of insulin

 

AN ailment we call diabetes today has been affecting the human species for thousands of years. Healers in ancient times noticed that ants were attracted to the urine of people with a mysterious disease — because of its sweet taste — a ‘diagnostic test’ of those times. 

Ancient Indians called it madhumeha. Greeks coined the term ‘diabetes’ and prescribed exercise preferably on horseback to control the condition. Ibn Sina, the great physician of the golden age of Islam, concocted a mixture of seeds as a panacea for the disease. But no one was able to develop an actual remedy.

Diagnosing the disease without treatment was of little use. Children suffered the most and died within weeks, sometimes days. Elders had to live with all the complications the disease brought.

In 1921, a group of Canadians was finally able to isolate insulin, a hormone without which the body is unable to use sugar (glucose). It was, indeed, one of the greatest medical breakthroughs of the 20th century. Just months later, Leonard Thompson, close to slipping into a diabetic coma, became the first person to be injected with insulin. Eli Lilly, a pharmaceutical firm in the US, won the right to mass-produce insulin for the first time. To date, millions of lives have been improved — and saved — owing to this once-in-a-generation discovery.

One in four adults in Pakistan is diabetic.

However, a century after its discovery, millions of people, particularly in low- and middle-income countries, continue to suffer from the disease. Many remain undiagnosed, and those who are diagnosed are not always able to afford continuous treatment.

Diabetes is estimated to have caused 6.7 million deaths — one every five seconds — in 2021. The global diabetes-related health expenditure is reaching a staggering figure of $1 trillion, a 316 per cent increase over the last 15 years.

The situation in Pakistan is particularly alarming. Pakistan has surpassed the US in the number of diabetic patients. One in four adults in the country is diabetic — the highest such figures in the world — according to the latest statistics from the International Diabetes Federation. In India, for example, one in 12 adults has diabetes, while in Bangladesh, this ratio is one in eight.

Close to 400,000 deaths in Pakistan could be attributed to this chronic disease in 2021 alone. Some 3.4m live births in the country were affected by an increased level of glucose in pregnancy. Diabetes is responsible for causing billions of dollars of healthcare expenses in Pakistan every year.

We sought the opinion of two experts on the matter: “Pakistan now ranks third in the world in the number of diabetic patients. Over 13m people in the country have been diagnosed as diabetic in the past two years alone. This is very concerning,” notes Dr Naveed Shehzad, an internal medicine specialist and endocrinologist focusing on diabetic care.

“Our country also has a very high number of patients having borderline diabetes. This condition could be reversed by eating healthily and regular exercise. Early screening can also help in diagnosing — and managing — the disease at an earlier stage. We must leave our lazy lifestyle, reduce the intake of fizzy drinks, and avoid unnecessary sugar intake,” concluded Dr Shehzad from Lahore.

It is one of those illnesses that can have a detrimental effect on the overall health if it remains uncontrolled. “Diabetes is the leading cause of kidney disease and can progress to kidney failure requiring dialysis. Effects of diabetes remain unnoticed in many patients until extensive damage has already been done,” says Dr Muhammad Saleem Akhter, a Pakistani-born consultant Nephrologist and Kid­ney Care Spe­cialist practicing at Bronx­Care Hospital, New York.

“Diagnosing diabetes early and monitoring kidney function regularly is of utmost importance. This could, for example, be done by measuring protein levels in the urine. Making lifestyle changes — such as quitting smoking, eating healthy foods, and exercising regularly — can help control the harmful effects of diabetes,” concluded Dr Akhter while commenting on the increasing prevalence of diabetes in Pakistan.

The advent of insulin a century years ago turned this life-threatening disease into a chronic condition requiring lifelong management. Despite active research, there is still no final cure for diabetes. Millions around the world await another miraculously scientific discovery that can perhaps cure the disease, once and for all.

Until then, eating healthy foods and choosing an active lifestyle can help control the disease and even lower the chances of getting type-2 diabetes, a form of disease more common in adults. People who are overweight must establish weight-loss goals. As the saying goes: Prevention is better than cure.

The question is: are we as a nation ready to take control of our health. If not now, when?

The writer is an entrepreneur pursuing innovations in at-home healthcare services.

Twitter: @DrHussainFarooq

Published in Dawn, December 11th, 2021