Diabetes in antiquity
The signs and symptoms of diabetes had been known to ancient physicians of different cultures. The cause of the disease remained a mystery until the late 19th century when the pancreas was identified as the causative organ. Its treatment only became available with the discovery of insulin in 1922 and later oral hypoglycaemic agents.
This site described the history of diabetes as shown on stamps. For more about the history of diabetes please refer to the references in the last section.
The Eber's Papyrus from ancient Egypt was regarded as the oldest medical textbook. The symptoms and treatment of diabetes were mentioned in the book. The page shown on this stamp relates to the symptoms of polyuria and its treatment. 
Hippocrates (460-377BC) wrote in his book Epidemics, Book III  the excessive passage of urine in people who developed ill health.
The Vedic scripture is a record of ancient Hindu medicine. Diabetes was described as a disease characterized by sweet tasting polyuria that attracts ants and flies and the development of gangrenes and recurrent infections in the sufferers.
In China, the Yellow Emperor, Huang Ti wrote in his book Nei Ching (Canon of Internal Medicine) the symptoms of diabetes: excessive thirst and polyuria. The stamp shows the tomb of Huang Ti.




Section 1 Epidemiology
1. Prevalence of retinopathy
Diabetic retinopathy is the commonest cause of blindness in the 
population of working age in developed nations and is of increasing 
importance in developing nations2,3. The prevalence of retinopathy 
varies with the age of onset of diabetes and the duration of the 
disease: in younger patients (below 30 years of age) the prevalence 
of retinopathy is minimal during the first 5 years but increases to 
greater than 95% after 15 years of diabetes4. in contrast, in patients 
whose onset of diabetes occurs after the age of 30, up to 20% may 
have signs of retinopathy on presentation with the prevalence in this 
group rising more slowly to approach 60% after 15 years of diabetes5.
In an insulin-treated subset of older-onset (>30 years) diabetic 
patients, 30% have signs of retinopathy at diagnosis, rising to over 
80% after 25 years of diabetes. More recent data on patients with 
non-insulin dependent diabetes mellitus (NIDDM) as part of the 
UK Prospective Diabetes Survey (UKPDS) indicate that the prevalence 
of retinopathy at diagnosis is 38%, using a single microaneurysm as 
evidence of retinopathy6
As a general statement, therefore, the prevalence of DR of any
severity in the diabetic population as a whole is approximately 30%7.
1.2 Prevalence of sight-threatening retinopathy
Most cases of DR are non-sight threatening. However, the pre-
valence of progressive retinopathy with risk of visual impairment is 
approximately 10%8
Accurate figures for the prevalence of  blindness (defined as 
VA <3/60 in the better eye) in the UK are not yet available. In the 
Wisconsin epidemiologic studies, the prevalence of proliferative 
retinopathy was 60% after 25 years of diabetes in younger diabetic 
patients, but in older diabetics it varied from 20 to 30% depending 
on whether they were insulin-treated or not. In contrast, diabetic 
macular oedema in 11% of younger diabetics and in 4% to 7% of 
older depending on their insulin requirement. Despite the lower 
overall rate of sight-threatening retinopathy in older patients, the 
prevalence of visual disability is greater in this group due to the much 
larger numbers of patients with NIDDM9. More recent data has shown 
that the incidence of macular oedema over a 10 year period was 20% 
in young diabetics, 25% in older age diabetics taking insulin and 14% 
in non-insulin-taking older diabetics. In addition, there appeared to be 
a correlation between incidence of macular oedema and poor diabetic 
control (see later)10.
The prevalence of blindness due to DR has thus been estimated to be 
approximately 5% (range 3-7%)11 and may be as high as 8%1. The 
annual incidence of new cases of sight-threatening retinopathy in 
the UK has been estimated to be approximately 1.2% of diabetics12
In order to eliminate this, screening programmes aimed a the diabetic 
population at risk of sight-threatening retinopathy, are presently being 
developed. Pilot studies indicate that 2.5-3% per annum of the screened 
population would require referral to an ophthalmologist.
Epidemiology Clinical features Risk factors Screening
Lasers and lenses. NVD,, NVE.. Maculopathy
Vitrectomy. Cataract Special problems Counselling
References.. AAO guidelines Atlas of Retinopathy Contact lenses
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