Learning About The Term's Meaning

The term "diabetes mellitus" actually covers several different disease processes. In this way it is similar to the term "common cold," which refers to a symptom complex, with a running nose, a feeling of general sickness, perhaps a fever, and usually a cough. We believe that the common cold is due to a virus infection, but actually a number of different viruses have been isolated that will produce the same symptoms. In a similar way, diabetes mellitus means that a person has an excess of sugar in his bloodstream, and that, if the condition is sufficiently advanced, the sugar will appear in his urine. Several different processes will result in these findings. The term thus covers several disease states. The reason for this overlap is that doctors recognized the symptoms before they knew the cause of the disease. Even today, the exact causes of most cases of diabetes mellitus are not known..

In the 1920s Banting, Best, and Macleod were able to prepare a substance, extracted from the pancreas of dogs, that was able to reduce the level of blood sugar in human beings. That substance was insulin. We do know that most persons with diabetes mellitus will benefit from injections of insulin, but we do not know why their own bodies are not producing an adequate amount of this hormone.

Insulin is produced in the pancreas, a gland located in the abdomen behind the stomach. The insulin is formed in a particular part of the pancreas, and in response to an increased level of sugar in the blood, this hormone is released into the bloodstream. The release of insulin is normally followed by a reduction in the amount of sugar in the blood. The sugar disappears into the liver, the muscles, and the fat deposits of the body. Some people develop diabetes who have diseases of the pancreas, such as a chronic inflammation of the gland, called chronic pancreatitis, or who have cancer of the pancreas. These patients have a form of diabetes mellitus which is easy to understand. The gland has been destroyed and therefore it cannot produce insulin. They usually have no trouble controlling their sugar problem with injected insulin.

The chemical structure of human insulin was not discovered until 1960. Shortly after that, a method was discovered to measure the amount of human insulin circulating in the bloodstream or present in the pancreas. Prior to this time the disease had been studied by indirect means, but now scientists can measure the deficits or excesses of insulin in diabetics.

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