Diabetes mellitus testing has changed over the years – Rapid City Journal

Testing for diabetes started a long, long time ago. The word diabetes comes from ancient Greek and literally means pass through," intended to mean excessive passing of urine.

This characteristic of too much urine was first described 3500 years ago on an Egyptian papyrus. About 1900 years ago, Roman physician Galen called it diarrhea of the urine. The reason for so much passing of urine with diabetes mellitus is because high levels of sugar in the blood overwhelm the kidneys' ability to keep sugar out of the urine. Like a dam on a river, sugar spills over the dam into the urine when sugar gets too high in the blood. Then, with concentrated sugar in the urine, fluid is pulled out of blood into the urine, resulting in dehydration of the diabetic. Indeed, the name diarrhea of the urine seems appropriate.

About 2500 years ago, someone noted flies were attracted to the urine of diabetics. Tasting urine for sweetness may seem disgusting today, but it was how they diagnosed diabetes all the way through the Middle Ages. It was English physician John Rolle who in the 1700's added mellitus to the term diabetes to reflect the age-old understanding of the sweet taste of the urine in diabetic patients. The word mellitus comes from Latin meaning sweetened with honey.

Starting in the 1950's, patients roughly estimated the level of sugar in their blood by testing their urine with a chemical test they could do at home. By determining how much sugar spilled into the urine, people with diabetes mellitus were better able to adjust their insulin dose. Home URINE glucose testing was an improvement for patients with diabetes, but home BLOOD glucose testing, developed in the '80's, took it to the next level. Patients could finally know when sugars were too low, not just too high.

Another great improvement in monitoring the blood sugar of diabetics was the development of the Hemoglobin A1c (HbA1c) BLOOD test. The hemoglobin molecule within red blood cells becomes more sugarized (the scientific word is glycosylated) when it has extended exposure to higher levels of sugar. Since red cells normally live for about three-months, we can monitor the percentage of Hemoglobin affected by sugar, watching it change slowly according to diabetic control. The HbA1c levels give a three-month average BLOOD sugar, which gives you and your care provider a good measure about how well you are controlling your diabetes over time.

It's a good thing managing diabetes no longer requires tasting urine.

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Diabetes mellitus testing has changed over the years - Rapid City Journal