TIME Diabetes

THE SYMPTOM—EXCESSIVE URINATION—was distinct, and the treatment, experimental: a regimen of elderberry, milk, green dates, and “water from the bird pond.” It was the Third Dynasty in Egypt, the patient was the Pharaoh Djoser, and the doctor, Hesy Ra, the ruler’s chief physician. There’s no record of whether Djoser’s condition improved, but today, more than 4,500 years later, his disease would receive a diagnosis familiar to many: type 2 diabetes. Medicine has come a long way since those pond water days, which is fortunate, because the demand for effective diabetes treatments has never been so great. Around the world, 529 million people are living with the disease. More than 1 in 10 Americans now have diabetes, according to CDC estimates. An additional 38 percent of Americans have pre-diabetes, which means…

IN THE FIFTH CENTURY BCE, A SURGEON in India described a patient’s honey-like urine, which was so sugary that it attracted ants. A few hundred years later, a physician in ancient China treated a person with a curious ailment that caused excessive thirst, frequent urination, and unexplained weight loss. These historical accounts are now cited as evidence that diabetes has been with us for thousands of years. Experts who study and treat the disease today say the early symptoms of type 2 diabetes would have been familiar to their predecessors of antiquity. “Increased urination, increased thirst, and unexplained weight loss are some of the first symptoms patients notice when their blood sugar levels are significantly elevated,” says Dr. Francisco Pasquel, a diabetes specialist and associate professor of endocrinology at Emory…

One of the dangers of type 2 diabetes is that it can develop quietly over a number of years, without obvious symptoms, as glucose levels rise and the body develops a resistance to insulin. This phase is known as prediabetes and often is discovered by accident, during routine medical work, when blood sugar levels register higher than normal, says Philip Orlander, MD, professor and endocrinologist with UTHealth Houston. You can also be tested specifically for prediabetes. A precursor to type 2, prediabetes has many of the same root causes as type 2, including excess weight, age (being older than 45); physical inactivity (exercising less than three times a week); having given birth to a baby who weighed more than 9 pounds; and having close family members who have type 2…

EARLY EACH YEAR, KRISTIN THOMPSON-Lerberg sits down with her husband to plan how they will reach the $3,000 deductible for their family’s insurance policy. The conversation historically was short: Thompson-Lerberg needs about eight vials of insulin each month to treat her type-1 diabetes, and at $275 per vial before insurance kicks in, it took just two months to reach the deductible with insulin alone. But the Thompson-Lerberg’s budget expanded in March 2023 after pharmaceutical giant Eli Lilly announced that the monthly out-of-pocket prices of their insulin brands would soon be capped at $35, regardless of a person’s insurance. For Humalog, the company’s best-selling insulin brand (and the one Thompson-Lerberg uses), the change amounted to a 70 percent cut in list price. The news from Eli Lilly was “life-changing for our…

A GROWING BODY OF RESEARCH IS finding links between how diet, weight, and environmental exposures, among other things, can affect the mix of bacteria that make up our microbiomes. There are still no clear guidelines for specific microbial combinations that could help avoid or treat disease, but the latest studies bring us closer to developing them. Starting in 2009, the U.S. National Institutes of Health invested $170 million to better understand the universe of bacteria that live within us—the socalled microbiome. In the first phase of the project, researchers focused on cataloging the myriad types of microbes found throughout the body, including in the mouth, nose, gut, and reproductive tract. The second phase of the research, described in three papers published in May 2019 in Nature and Nature Medicine, focused…

Probiotics have long been star ingredients in dairy foods, drinks, and supplements, promising to generate a better bacterial balance to our guts. In 2023, the U.S. Food and Drug Administration took a step toward formalizing the idea of adjusting gut-bacteria populations when it approved the first oral drug designed to treat the microbiome. First called SER-109, and now VOWST, the pill is a cocktail of bacteria that can prevent recurring infections of C. difficile bacteria in people who have had previous episodes and help them maintain healthy levels of gut bacteria. Keeping beneficial bacteria in proper balance could be an important way to keep disease-causing ones like C. difficile at bay. The FDA based its decision on clinical trials that the drug’s maker, Seres Therapeutics, conducted in collaboration with Nestle…