Pathological skeletal remains from ancient Egypt: The earliest case of diabetes mellitus?

Abstract

The diagnosis of diabetes mellitus from skeletal remains is very difficult given the complexity of the disease and the fact that there are no pathological skeletal characteristics exclusively associated with diabetes mellitus. Skeletal identification of diabetes mellitus may only be possible through differential diagnosis, when several pathological changes are present. Skeletal and dental changes associated with diabetes mellitus include Charcot's joint (neuropathic arthropathy), osteoporosis, osteoarthritis, diffuse idiopathic skeletal hyperostosis (DISH, or Forestier's disease), adhesive capsulitis (frozen shoulder), dental caries, periodontal disease, and antemortem tooth loss. Skeletal remains of an adult male from the Egyptian archaeological site of Dayr al-Barsha, dated to the Middle Kingdom (ca. 2055-1650 BC), display a myriad of pathological conditions that, when considered together, likely indicate diabetes mellitus, specifically type 2 diabetes mellitus. This diagnosis represents the earliest, and possibly the only recorded archaeological skeletal evidence for this disease. © 2010 John Wiley & Sons.