Dark History: Urine Beer, Insulin Comas, and Ozempic - The Dark History of Diabetes
In episode 155 of Dark History, hosted by Bailey Sarian, the intricate and often harrowing journey of diabetes treatment is explored. From ancient remedies to modern pharmaceuticals, the episode delves deep into how humanity has grappled with this chronic disease over millennia.
Introduction to Diabetes
Bailey Sarian kicks off the episode with a personal anecdote, emphasizing the pervasive nature of diabetes:
"Unless you've been living under a rock, you've probably heard about the latest wonder drug that's been on the market. Ozempic."
— [01:02]
She highlights the historical significance of diabetes, a disease dating back to the time of Neanderthals, underscoring its enduring impact on human health.
Historical Overview
Ancient Egypt and Early Observations
The journey begins in Ancient Egypt around 1550 B.C., where early physicians, though limited by their understanding, observed symptoms indicative of diabetes:
"They had this insatiable, unquenchable thirst, and they were peeing a lot. On top of all that, their pee was sticky and had a certain sweet smell."
— [02:30]
Dr. Shu Shruta, an ancient Hindu doctor, documented these observations, coining the term madhumita or "honey urine," recognizing the presence of sugar in the urine of afflicted individuals.
Ancient Greece and Naming Diabetes
Fast forward to the ancient Greeks, who not only named the disease "diabetes" — meaning "to pass through" — but also employed unconventional diagnostic methods:
"They would determine whether someone had diabetes by tasting a patient's urine. We're not judging. They had to know. It was science."
— [05:15]
Despite these early insights, effective treatments remained elusive, leaving patients to succumb to the debilitating effects of the disease.
Middle Ages and Medieval Approaches
During the Middle Ages in Europe, diabetes was infamously dubbed the "pissing evil." Treatments were largely ineffective and often harmful:
"Doctors were literally prescribing less than 300 calories per day. This meant that patients would just starve to death before the diabetes could kill them."
— [06:45]
Alternative and extreme dietary regimens, including the consumption of raw meat and opium-laden concoctions, were commonplace, offering little respite to sufferers.
The Discovery of Insulin
Identifying the Pancreas Connection
A significant breakthrough came in 1889 when German scientists Oskar Minkowski and Joseph von Mering connected the pancreas to diabetes. By removing the pancreas from a dog, they induced a diabetic state, demonstrating the organ's crucial role in regulating blood sugar:
"By removing the pancreas, Dr. Minkowski and Dr. von Mering had given this dog type 1 diabetes. I know, sadly, though, the dog died shortly after his pancreas was removed."
— [12:10]
This discovery was pivotal, laying the groundwork for future treatments.
Isolation and Introduction of Insulin
In 1921, Canadian scientist Dr. Frederick Banting and his assistant Charles Best successfully isolated insulin. Their landmark treatment on a 14-year-old boy, Leonard Thompson, marked the first use of insulin therapy in humans:
"On January 11, 1922, Leonard became the first ever human being to get an insulin injection from Banting and Best. But it didn't do much for him... until James Collip refined the insulin formula, after which Leonard's condition improved dramatically."
— [14:20]
This medical marvel not only saved countless lives but also earned Dr. Banting a Nobel Prize in 1923.
The Pharmaceutical Industry and Insulin
Early Insulin Treatments and Misuses
Initially, insulin was extracted from animal sources, requiring painful injections. Over time, advancements led to lab-produced human insulin, enhancing safety and accessibility. However, the fame of insulin also led to its misuse:
"From the 1920s all the way through the 60s, doctors started using it on schizophrenic patients to put them in literal comas."
— [17:30]
This period saw insulin being repurposed in ethically questionable ways, reflecting the complexities of pharmaceutical advancements.
Rising Costs and Accessibility Issues
Despite insulin's life-saving properties, its affordability became a significant issue. Bailey highlights the disparity between production costs and market prices:
"Insulin is actually factually pretty cheap to produce. So the high cost is entirely based on pharma companies upcharging because they know people literally can't live without it."
— [22:24]
The price surge between 2017 and 2022, a 24% increase, led to dire consequences, including rationing and, tragically, deaths:
"In 2017, there was a 22-year-old diabetic woman who had her insulin covered by her insurance... without her insulin, she died."
— [23:10]
Activism and Efforts to Curb Prices
In response to soaring insulin costs, activism surged under banners like #insulin4all. Organizations and movements pressured pharmaceutical giants to lower prices:
"There's this company called Type 1 International and a hashtag going around that's #insulin4all. They are putting pressure on big pharma companies like Eli Lilly and Novo Nordisk."
— [25:00]
States like Ohio and North Dakota took legislative steps to cap insulin prices, aiming to make the life-saving drug more affordable.
The Rise of Ozempic
From Ancient Lizards to Modern Medicine
The story of Ozempic (Semaglutide) is a fascinating tale of scientific discovery and market dynamics. Originating from research on the venom of the Gila monster, a venomous lizard, scientists identified a hormone that could stimulate insulin production:
"Dr. John Eng discovered something in the Gila venom, which he named Exendin-4. Exendin-4 was similar to GLP-1, which could stimulate the pancreas to create insulin and was more shelf-stable."
— [31:00]
This breakthrough led to the development of Byetta in 2005, followed by Ozempic in 2017, which offered the added benefit of weight loss with fewer injections.
Ozempic’s Surge in Popularity and Consequences
Ozempic quickly transcended its original purpose as a diabetes medication to become a sought-after weight loss solution, popularized by celebrities and social media trends:
"In 2022, Ozempic blew up on TikTok when people were posting under the hashtag #myozempicjourney."
— [29:10]
However, this surge in demand led to significant shortages, adversely affecting diabetic patients who relied on the drug for blood sugar management.
Current Challenges and Future Outlook
Pharmaceutical Greed and Its Impact
Bailey doesn't shy away from criticizing the pharmaceutical industry's role in insulin pricing:
"Insulin manufacturers have jacked up the price in order to make more profit... thousands of people are having a hard time getting the medication they need to survive."
— [27:15]
This greed-driven pricing exacerbates the diabetes epidemic, which continues to rise globally due to modern lifestyles and diets.
Innovative Treatments on the Horizon
Despite these challenges, there's hope on the horizon. Innovations like stem cell treatments offer potential cures:
"Just recently, there was a stem cell treatment that was done on a 25-year-old woman with type 1 diabetes. This treatment allowed the woman to start producing her own insulin in less than three months."
— [26:50]
While still in experimental stages, such advancements could revolutionize diabetes treatment in the future.
Conclusion
Bailey Sarian wraps up the episode by emphasizing the enduring struggle against diabetes and the critical need for affordable, accessible treatments.
"Diabetes has been around for a very long time... and people need insulin and insulin should be affordable. I think we can all agree on that."
— [27:53]
The episode serves as a poignant reminder of the intersection between medical science, pharmaceutical ethics, and societal responsibility in the ongoing battle against diabetes.
Expert Insight: Special thanks to Stuart Bradwell, author of Insulin: A Hundred-Year History, for his invaluable expertise that enriched today's discussion.
Stay Tuned: Join Bailey next week as she explores the dark history of America's presidents, delving into their personal obsessions and secrets.
This summary captures the essence of Bailey Sarian's exploration of diabetes' dark history, highlighting the key developments, ethical dilemmas, and ongoing battles within the medical and pharmaceutical fields.