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Keto Type 1 Diabetes

Notes of a diabetic case.

John Rollo

Royal College of Physicians of London 1796

A 1797 case report by John Rollo describes treating diabetes with a strict animal‑based, low‑carbohydrate diet and monitoring urine sugar, noting rapid symptom improvements.

Study Details

Journal Royal College of Physicians of London
Year 1796
URL: wellcomecollection.org
1 min read

Table of Contents

A Historical Document

This is a historical medical case report titled “Notes of a diabetic case” by John Rollo (1797), published in Deptford. It documents how a physician observed and treated a patient with what we’d now call diabetes, focusing on symptoms, urine sugar, and dietary intervention. It’s in the public domain and preserved by the Royal College of Physicians and Wellcome Collection.

What it actually says

  • Rollo presents a detailed account of a diabetic patient where urine contained sugar and the patient had classic symptoms: excessive urination, thirst, weight loss, and weakness.
  • The core intervention was removing most carbohydrates from the diet and emphasizing animal foods (meat, fat), with careful attention to hydration and symptom tracking.
  • He reports rapid and noticeable changes: reduced urine volume, declines in sugar excretion, improved strength, and better overall condition when carbohydrates were restricted.
  • Attempts to reintroduce carbohydrate foods led to a return of sugary urine and symptoms, reinforcing the link between carbohydrate intake and diabetic signs in this patient.
  • The report emphasizes frequent measurement of urine and clinical signs to guide treatment, rather than abstract theory.

Not the first record of Diabetes

Rollo’s “Notes of a diabetic case” is an early modern clinical report, but diabetes was described long before. Ancient sources note hallmark features like excessive urination, thirst, weight loss, and sweet urine. The Ebers Papyrus from c. 1550 BC likely references a syndrome consistent with polyuria; Indian Ayurvedic texts in the 5th–6th century BC explicitly describe “madhumeha” (honey urine) and distinguish forms akin to type 1 and type 2; Chinese medical classics detail “wasting-thirst” with diagnostic and treatment approaches. ​⁠https://en.wikipedia.org/wiki/History_of_diabetes

A medical history review places the first accurate description and naming of “diabetes” with Aretaeus of Cappadocia in the 2nd century AD, and the “mellitus” qualifier (sweet urine) added by Thomas Willis in the 17th century. ​⁠https://pmc.ncbi.nlm.nih.gov/articles/PMC4707300/

So, Rollo’s 1797 report is among the earliest detailed, data-driven Western case treatments, but not the first documentation of the disease itself, which has roots in ancient Egyptian, Indian, Chinese, Greco‑Roman, and Islamic medical literature. ​⁠https://www.news-medical.net/health/History-of-Diabetes.aspx