Diabetes was rare before the twentieth century.  Management of Diabetes started with severe caloric restriction for mere survival of patients with type 1 diabetes.

Banting and Best, Mc Cleod and Collip, discovered and purified insulin from the canine pancreas.  In 1935 diabetes with insulin resistance was distinguished from type 1 diabetes.

Longer acting insulins were marketed from the 1930s while the first generation of sulphonylureas (a class of oral medications) was introduced in the 1950s.

Prior to the 1960s blood glucose was tested using doctor’s office or home urine kits with test tubes.  The first blood glucose meter from Aimes Diagnostic appeared in 1969 and at the time weighed three pounds and cost US$650.

The single use syringe was introduced in 1961 and this replaced reusable needles that became blunt with time and were sterilised by boiling in water for 20 minutes.

The first portable insulin pumps appeared in the late 1970s and these weighed over one pound and had to be carried in a backpack.

Some important clinical studies happened in the late 20th century.  The DCCT from 1983 to 1993 showed that tight blood glucose control is beneficial to prevent complications such as retinopathy and nephropathy.

The most commonly recommended oral medication for type 2 diabetes, Metformin, was approved for use in 1995 and researched continued on rapid acting insulin and alternative oral medications.