United Nations Diabetes Day丨Xie Kehe Hospital Carves a History of Diabetes

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Guest speaker: Professor Li Naishi

Records of diabetes can be traced back to around 1500 BC, with the symptoms of diabetes polydipsia and polyuria recorded on papyrus in ancient Egypt. In ancient China, diabetes was also known to some extent before BC.

Nalan Xingde, an outstanding poet in the early Qing Dynasty, wrote in his poem "Linjiangxian: Thanking for the Cherries": " Lying alone in Wenyuan, I felt sick and thirsty. " The " Wenyuan " here refers to Sima Xiangru, a famous rhetorician in the Western Han Dynasty, and " sick and thirsty " refers to diabetes, which vividly highlights the two prominent clinical manifestations of diabetic patients: " weight loss " and " thirst ".

Because of Sima Xiangru, diabetes was also elegantly called " Wenyuan disease ", and Sima Xiangru was used as the magistrate of Xiaowen Garden. Sima Xiangru was born and died between 200 and 100 BC, which shows that diabetes had a very clear name at that time.

Although diabetes is an ancient disease, there have not been many effective ways to treat it for a long time.

In his book Treatise on the Causes and Symptoms of Various Diseases, Chao Yuanfang, a famous doctor in the Sui Dynasty of China, proposed that diabetes is " caused by obesity ." It can be said that this understanding was very profound, and it pointed out the importance of controlling diet. On the other hand, he also proposed an exercise intervention plan of "walking one hundred and twenty steps first, or as many as one thousand steps" before meals.

These measures all indicate that people at that time had recognized that lifestyle adjustments were part of diabetes treatment, but effective therapeutic drugs had to wait until the advent of insulin in 1921 .

Best (left) and Banting (right) with the dog number 406

The story of Banting and Best discovering insulin during the summer vacation of 1921 is already well known to everyone, but the actual mass production of insulin actually occurred in early 1923.

In the early days of Peking Union Medical College Hospital, we were able to keep pace with the rest of the world in the treatment of diabetes. In our historical medical records, the earliest medical record of a diabetic hospitalization was case number 45, and the time of admission was March 1921; the first medical record of diabetes treated with insulin was case number 5524, and the time of using insulin was July 1923.

The doctor who wrote the medical record was Hou Xiangchuan , the first graduate of Peking Union Medical College. He was an intern at the time. He specially plotted the blood sugar monitoring values ​​on the coordinate paper. The curve of not eating after insulin injection and the curve of eating immediately after insulin injection were all clearly visible on this coordinate paper.

After that, Dr. Le Wenzhao and Dr. Mills from the Department of Internal Medicine also quickly wrote a case analysis of the use of insulin to treat diabetes. However, the master of diabetes diagnosis and treatment was Wang Shuxian , who graduated from Peking Union Medical College in 1930. His paper published in 1937 summarized and organized the inpatient cases of diabetes since the establishment of Peking Union Medical College Hospital and conducted a detailed retrospective analysis, which became the largest and most comprehensive population study on diabetes before the founding of New China.

After the founding of New China, Professor Liu Shihao , the first director of the Department of Endocrinology of Peking Union Medical College and the founder of China's endocrinology, conducted a diabetes survey on the population of the Capital Steel Plant in 1964. Although it was not published due to the times, it cultivated leading talents in China's endocrinology such as Shi Yifan and Pan Xiaoren .

During the same period, American scientists Berson and Yale invented the radioimmunoassay for insulin, which became a major breakthrough in promoting clinical endocrinology; in 1962, Liu Shihao recruited graduate student Chen Zhizhou (later a professor at the Cancer Hospital of the Chinese Academy of Medical Sciences), and under the joint guidance of Xie Shaowen, Wang Shizhen and Xu Jiansheng, he finally independently tackled this key technology in 1965.

At the beginning of reform and opening up, Professor Chi Zhisheng, the second director of the Department of Endocrinology at Peking Union Medical College, led several domestic teams to conduct epidemiological research. From the data of that period, he concluded that the standard for fasting blood sugar in the diagnostic criteria for diabetes in Chinese people should be 125 mg/dl, which is surprisingly consistent with the standard revised by the World Health Organization in 1999 (126 mg/dl, i.e. 7.0 mmol/L).

All is past...

In the past 30 years, new achievements in the prevention and treatment of diabetes have emerged one after another. The "weapons" we can use now are much more advanced and richer than those 100 years ago, but we have not yet conquered this stubborn disease. The theme of this year's United Nations Diabetes Day is "Diabetes and Happiness", which requires us to go deeper into the grassroots, carry out more diabetes science popularization, and help the general public improve their lifestyles and effectively prevent and treat diabetes and complications, so that diabetic patients can truly gain a sense of happiness.

Editor: Liu Yang and Zhao Na

Proofread by Li Na and Li Yule

Producer: Peng Bin

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