| 1552 BC
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On a 3rd Dynasty Egyptian papyrus, physician Hesy-Ra mentions frequent urination as a symptom - the earliest known record of diabetes.
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| 1500 BC
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Ancient Hindu writings note that ants are attracted to the urine of people with a mysterious emaciating disease.
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| ca 500 BC
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First descriptions of sugar in the urine and occurrence in obese individuals (type 2).
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| 250 BC
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Apollonius of Memphis probably coins the name "diabetes" - "to go through" or siphon - for a disease that drains patients of more fluid than they can consume. In the first century AD, the Greeks describe the disease as "a melting down of the flesh and limbs into urine."
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| 164 AD
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Greek physician Galen of Pergamum diagnoses diabetes as a kidney ailment.
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| 1000 AD
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Greek physicians prescribe exercise, preferably on horseback, to "employ moderate friction" and alleviate excess urination.
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| Up to 11th Century
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Since the urine of people with diabetes is thought to be sweet tasting, diagnosis is often made by "water tasters" who drink the urine of those suspected of having diabetes. The Latin word for honey - mellitus - is added to the term diabetes.
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| 16th Century
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Paracelsus identifies diabetes as a serious general disorder.
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For thousands of years, no one knows how to live with, let alone treat or cure, diabetes. Children with diabetes often die within days of onset, and older people deal with devastating complications. Remedies range from herbs to "cataplasms to the hypochondrium over the kidneys" to opening the veins.
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| 1674
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The observations of Willis initiate a new era of diabetes research in England. He states that the urine of diabetics is sweet - a fact not recognized since the time of early Hindu medicine. Diabetes is associated with "good fellowship and guzzling down of ... wine."
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| 1776
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Dobson finds a substance like brown sugar in appearance and taste when diabetic urine evaporates. He also notes a sweetish taste of sugar in the blood of diabetics. He observes that, for some people, diabetes is fatal in less than five weeks and is a chronic condition in others. (This is the first modern distinction between type 1 and type 2.)
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| 1797
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Rollo applies the first significant dietary approach to the treatment of diabetes. He successfully treats a patient using a high fat and protein diet after observing that sugar in the urine increases after eating starchy food.
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| 1798
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Rollo documents excess sugar in the blood as well as the urine.
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Before the mid 1800s, treatment often consists of bleeding, blistering, and doping.
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| Early 1800's
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Researchers develop the first chemical tests to indicate and measure the presence of sugar in the urine.
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| 1848
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Bernard discovers that sugar is formed by the liver (glycogen), and speculates that this is the same sugar found in the urine of diabetics - the first linking of diabetes and glycogen metabolism.
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| late 1850s
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The French physician, Priorry, advises diabetes patients to eat extra large quantities of sugar as a treatment.
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| 1869
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Langerhans, a German medical student, announces in a dissertation that the pancreas contains two systems of cells - one set secreting the normal pancreatic juice, the function of the other unknown. Later, these cells are identified as the "islets of Langerhans".
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| 1870s
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French physician, Bouchardat, notices the disappearance of sugar in the urine of his diabetes patients during the food rationing in Paris during the Franco-Prussian War and formulates the idea of individualized diets.
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| 1889
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Minkowski and von Mering at the University of Strasbourg, France, remove the pancreas from a dog to determine the effect on digestion and discover that diabetes develops.
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| 19th Century
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Pavlov discovers the links between the nervous system and gastric secretion, making an important contribution to our knowledge of the physiology of the digestive system.
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| Late 19th Century
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Italian diabetes specialist, Catoni, keeps his patients under lock and key to get them to follow their diets.
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In 1897, the average life expectancy for a 10-year-old child with diabetes is about 1 year. Diagnosis at age 30 carries a life expectancy of about 4 years. A newly diagnosed 50-year-old might live 8 more years.
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| 1908
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Zuelzer extracts a pancreatic "substance" and injects it into five diabetes patients. Although sugar in the urine is reduced or disappears, the side effects of treatment are extreme and unacceptable.
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| 1909
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de Meyer of Belgium proposes the name "insulin" (Latin: insula, island) for the unknown pancreatic substance.
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| 1911
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Benedict devises new method to measure urine sugar (Benedict's Solution).
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| 1900-1915
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Diabetes treatment includes: the "oat-cure" (daily allowance is approximately eight ounces of oatmeal mixed with eight ounces of butter, eaten every two hours), the milk diet, the rice cure, "potato therapy", opium, and overfeeding to compensate for the loss of fluids and weight.
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| ca 1913
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Allen's book, Studies Concerning Glycosuria and Diabetes, stimulates a revolution in diabetes therapy.
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| 1910-1920
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Allen and Joslin are considered the two leading diabetes specialists in the United States. Joslin believes that diabetes is "the best of the chronic diseases" because it was "clean, seldom unsightly, not contagious, often painless and susceptible to treatment".
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| 1916
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Allen promotes a rigid, cruel "starvation treatment", which is soon widely adopted. Allen believes that the diabetic's body cannot use food; limiting the amount of food allowed reduces the strain. Patients are admitted to the hospital and given only whiskey mixed with black coffee every two hours from 7 am to 7 pm. (Clear soup could substitute for whiskey.) This diet is maintained until there is no sign of sugar in the urine - usually less than five days. A strict diet follows. Outcomes are better than ever seen before for those with what we call type 2. Sadly, those with type 1 commonly die from starvation. A few young people do survive and become the first insulin users.
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| 1919
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Allen publishes Total Dietary Regulation in the Treatment of Diabetes, with exhaustive case records and observations of 76 of his 100 diabetes patients. He becomes the director of diabetes research at the Rockefeller Institute.
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| 1919-1920
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Allen establishes the first treatment clinic in the USA, the Physiatric Institute in New Jersey, to treat patients with diabetes, high blood pressure and Bright's disease.
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| 1920
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Banting conceives of the idea of insulin after reading Moses Barron's The Relation of the Islets of Langerhans to Diabetes with Special Reference to Cases of Pancreatic Lithiasis in the journal Surgery, Gynecology and Obstetrics. With help from Best, Collip and Macleod, Banting continues experimenting with different pancreatic extracts on de-pancreatized dogs.
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| 1921
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Paulescu, a distinguished Romanian scientist, publishes an article describing his successful isolation of "pancreine" - insulin. (He is not recognized for another 50 years even though he publishes his results several months before Banting and Best publish theirs. He obtains patent for "pancreine" in 1922.)
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| 1921
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Insulin is "discovered". A de-pancreatized dog is successfully treated with insulin.
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| 1921
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Banting presents The Beneficial Influences of Certain Pancreatic Extracts on Pancreatic Diabetes, summarizing his work at a session of the American Physiological Society at Yale University and receives little praise or congratulation. (Allen and Joslin are attendees.)
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Before insulin, everyone with type 1 diabetes dies within a few years of diagnosis. Most diabetic women are sterile, or, if they become pregnant, abort. Half of the babies and one-fourth of the mothers die if they go to term. Today, with adequate medical supervision, less than 1 percent of pregnant diabetic women die of diabetes during pregnancy or post-partum.
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| 1922
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In Toronto, one of Collip's insulin extracts is tested on a human being, a 14-year-old boy named Leonard Thompson. This test is considered a success by the end of the following February.
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| 1922
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Eli Lilly and the University of Toronto stike a deal for the mass production of insulin in North America.
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| 1923
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Banting and his colleague Macleod are awarded the Nobel Prize in Physiology or Medicine. Banting shares his award with Best; Macleod shares his with Collip.
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|
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While insulin can prevent early death from diabetic coma, insulin treatment does not prevent the chronic, disabling and sometimes deadly complications of the disease.
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| 1923
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Eli Lilly begins commercial production of insulin. The Toronto group calls the substance "insulin"; Eli Lilly calls their product "Isletin Insulin."
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| ca 1925
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Home testing for sugar in the urine is introduced. Eight drops of urine is mixed in a test tube with 6 cc (1 tsp=5 cc) of Benedict's solution provided by the doctor. The tube is put into boiling water for five minutes. The color of the liquid indicates the presence of sugar: greenish (light sugar), yellow (moderate) or red/orange (heavy).
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| 1927
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An oral medication called "horment" or "glukohorment" is developed by a commercial Europen firm as a replacement for insulin, but side effects are unacceptable.
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| 1930s
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Insulin is further refined. Protamine zinc insulin, a long-acting insulin that provides more flexibility, is introduced. (It remained on the market until several years ago.)
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| 1936
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Research by Himsworth (UK) divides diabetics into two types based on "insulin sensitivity."
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| 1940's
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The connection is made between diabetes and long-term complications - kidney and eye disease.
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| 1940's
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Insulin continues to be further refined and purified. NPH insulin (neutral protamine Hagedorn) is introduced.
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| 1944
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Loubatières evaluates an anti-bacterial drug for the treatment of typhoid fever and notes that some patients die of prolonged low blood sugar. (His research ultimately results in the development of the first acceptable oral medication for type 2 diabetes in the mid-50's.)
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| 1944
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A standard insulin syringe is developed and diabetes management becomes more uniform.
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By 1945, a newly diagnosed 10-year-old has a life expectancy of 45 years; a 30-year-old has 30.5 more years; and a 50-year-old might have 16 more years to live. The life expectancy for people with diabetes in 2004 is still lower than that for the general population by about 15 years.
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| 1948
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Joslin writes about the "unknown diabetic" in Postgraduate Medicine. Although a million people are known to have diabetes, he speculates a million more have it but don't know it. He is likely the first expert emphasizing that insulin cannot solve all diabetes-related issues.
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| late 1940's
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Helen Free develops the "dip-and-read" urine test (Clinistix) allowing instant monitoring of blood glucose levels.
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| 1950s
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The lente series of insulin is introduced.
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|
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Specialists still recommend against marriage for people "with hereditary diabetes".
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| 1951
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Lawrence and Bornstein measure the amount of insulin in the blood. They find that older and obese patients with diabetes do have insulin, but those who are young have none.
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| 1954
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Diabetes Association of Greater Cleveland founded. Funding diabetes research and supporting young researchers is an important part of the DAGC mission.
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| 1955
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Oral drugs that help lower blood glucose levels are introduced.
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| 1959
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Two major types of diabetes are recognized: type 1 (insulin-dependent) diabetes and type 2 (non-insulin-dependent) diabetes.
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| 1959-1960
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Yallow and Berson develop the radioimmunological assay (RIA) procedure, measuring insulin with much greater precision than earlier techniques. Yallow receives the Nobel prize in 1977.
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| 1960s
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Insulins are now more highly purified due to advances in chromatography - a method for analyzing complex mixtures by separating them into the chemicals from which they are made.
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| 1960's
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Home testing for glucose levels in the urine increases the level of control for people with diabetes.
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| 1964
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The first strips for testing blood glucose are used. A drop of blood is placed on the paper strip for 1 minute, and then washed off. Comparing the color to a color chart provides a rough indication of blood glucose levels.
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| 1965
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Instant glucose is developed.
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| 1966
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Doctors at the University of Manitoba perform the first pancreas transplant.
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| 1970
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First blood glucose meter (Ames) is introduced. It is intended for use in doctors' offices and costs around $500.
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| 1970
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Insulin pumps are developed.
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Blood glucose self- management gives patients greater control and flexibility in managing diabetes. The worldwide market for blood glucose meters is several billion dollars per year and continues to grow.
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| 1970
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Laser therapy is used to help slow or prevent blindness in resulting from diabetes.
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| 1973
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U-100 insulin is introduced.
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| 1976
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The glycosylated hemoglobin (A1C) test is introduced.
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| 1977
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A pilot program for gestational diabetes is developed with the Cleveland Regional Perinatal Network.
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The manufacture of insulin changes dramatically with the advent of DNA technology that allows synthesis of a genetically engineered "human" type of insulin. Manufacturers no longer have to stockpile animal pancreatic tissue.
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| 1978
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Production of the first recombinant DNA insulin is announced.
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| 1978
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The National Diabetes Information Clearinghouse (NDIC) - an information dissemination service of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK - part of the National Institutes of Health (NIH)) - is established to increase knowledge and understanding about diabetes among patients, health care professionals, and the general public.
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| 1979
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Type 1 and Type 2 diabetes are formally recognized by the American Diabetes Association. Type 1 is also called Insulin Dependent Diabetes Mellitus (IDDM), and Type 2 is called Non Insulin Dependent Diabetes Mellitus (NIDDM).
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| 1983
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The first biosynthetic human insulin is introduced.
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| 1983
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"Reflolux", later known as "Accu-Chek", allows blood glucose self-monitoring.
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| 1983
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DCCT study begins with Cleveland as 1 of 21 research center sites in the US.
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| 1986
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Insulin pen delivery system is introduced.
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| 1993
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The landmark clinical trial Diabetes Control and Complications Trial (DCCT) publishes its report, clearly demonstrating that intensive therapy (more frequent doses and self-adjustment according to individual activity and eating patterns) delays the onset and progression of long-term complications in type 1 individuals. The study results show risk reduction for complications of 76% for eye disease, 50% for kidney disease, and 60% for nerve disease.
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| 1993
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Instant Glucose tablets are introduced.
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| 1995
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Center for Diabetes Research at Case School of Medicine is established.
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| 1996
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The FDA approves the first recombinant DNA human insulin analogue, lispro (Humalog).
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| 1990-1997
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External insulin pumps allow closer control and freedom from multiple injections. More sophisticated insulin analogues are introduced offering faster action, less risk of reactions, and more flexibility for diabetes management.
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More than 300 insulin analogues have been identified (including about 70 animal insulins, 80 chemically modified insulins, and 150 biosynthetic insulins) allowing more customized treatment, reduced side effects, and improved outcomes.
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| 2001
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FDA approves Cygnus' first-generation model of the GlucoWatch Biographer for use by adults - the first frequent, automatic and non-invasive glucose monitor.
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| 2003
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The names Insulin Dependent Diabetes Mellitus (IDDM) for Type 1 and Non Insulin Dependent Diabetes Mellitus (NIDDM) for Type 2 diabetes are formally dropped.
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| 2003
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DAGC establishes the Dietrich Diabetes Research Institute.
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| Today
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Researchers are working on an insulin patch and inhaled insulin.
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Deaths due to diabetes complications like cardiovascular disease are declining.
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Genetic engineering is being used to manipulate cells so they secrete insulin.
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Improved approaches to managing diabetes in pregnant women increase the successful outcomes for mother and child.
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A sensor-computer-pump system that mimics the insulin response of the normal pancreas is being developed to function as an "artificial pancreas".
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| Right here in Cleveland, researchers are conducting hundreds of diabetes-related projects focused on preventing diabetes, improving care to prevent and reduce its devastating complications, and finding a cure for both Type 1 and Type 2 diabetes.
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Coming Soon - the Dietrich Diabetes Database will allow you to view the exciting diabetes research taking place in northeast Ohio.
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