Lecture Notes: The Antibiotics Revolution and Diabetes Mellitus

The Antibiotics Revolution

• Impact on Infectious Diseases:
  • Antibiotics revolutionized the treatment of infections.
  • Bacterial infections, once the leading cause of death, are now less common in developed countries.
  • Shift in the top-ten list of diseases to heart disease, cancer, and chronic illnesses.
• Increased Lifespan:
  • 20th-century developments increased average human lifespan.
  • Successful combat against pathogens through antibiotics and immunization.

Challenges with Non-Infectious Diseases

• Focus Shift:
  • Non-infectious diseases are now more prominent due to intrinsic biology and aging.

Introduction to Diabetes Mellitus

• Historical Overview:
  • Ancient documentation from Egypt (Ebers Papyrus).
  • Described polyuria as a symptom.
  • Ancient treatments ineffective.
• Greek and Roman Medicine:
  • Greek and Roman doctors observed excessive urination and sweet-tasting urine.
  • "Diabetes" term introduced by Galen and Aretaeus.
• Middle Ages:
  • Limited progress in understanding diabetes.
  • Maimonides' incorrect theory on cause.

Development in Diabetes Understanding

• Renaissance and Beyond:
  • Experimental medicine and scientific discoveries began.
  • Thomas Willis' hypothesis on blood origin of diabetes.
• 19th Century Discoveries:
  • Minkowski’s experiment on pancreas removal confirming diabetes onset.
  • Langerhans' discovery of pancreatic site for glucose control.

Breakthroughs in Diabetes Treatment

• Insulin Discovery:
  • Early 20th century identified insulin production in pancreas.
  • 1921: Frederick Banting’s successful insulin extraction.
  • Dramatic health improvements in diabetes patients.
  • 1923: Banting and MacLeod awarded Nobel Prize.
• Insulin Production and Advances:
  • Initially extracted from animals; purified in 1926.
  • 1951: Insulin structure determined by Frederick Sanger.
  • Recombinant DNA technology in the 1980s facilitated human insulin production.
• Controversies and Challenges:
  • Anti-science movements opposed recombinant DNA technology.
  • 1982: Approval of Humulin, first recombinant human insulin.

Modern Diabetes Management

• Insulin Modifications:
  • Development of insulin analogs like insulin glargine.
  • Improved solubility and absorption properties.
  • Allows for controlled insulin delivery to stabilize glucose levels.
• Technological Advancements:
  • Devices for monitoring glucose and administering insulin.
  • Mitigation of complications like blindness and kidney failure.

Conclusion

• Ongoing Challenges and Perceptions:
  • Diabetes often underestimated due to treatment advancements.
  • Importance of awareness and proper management to prevent complications.
• Historical Significance:
  • Insulin isolation revolutionized treatment, changing diabetes from a fatal diagnosis to a manageable condition.