The Discovery of Insulin – The 10th Decade

Insulin was discovered early in the 20th century and it changed the prognoses for people with diabetes. The first patient was treated with insulin in 1922 and now insulin therapy is nearing its 10th decade in use. Discover how the discovery of insulin brought new hope to people with diabetes and why it continues to be a viable therapy.

• Insulin research dates back to 1869 when a German medical student, Paul Langerhans, discovered what would someday be referred to as insulin-producing beta cells. Three decades later, a German physiologist named Oskar Minkowski, MD and a physician named Josef von Mering MD found when a pancreas gland was removed from a dog, the animal would get symptoms of diabetes and soon die. This is when doctors learned the pancreas played a big role in metabolizing sugar.
• A Toronto-based surgeon, Frederick Banting, MD, found a publication in 1920 that piqued his interest in duct ligation. He went on to develop insulin therapy for the treatment of diabetes with the assistance of J.J. R. Macleod, MD, J. Bertram Collip, MA, PhD and C.H. Best. In January, 1922, 14-year-old Leonard Thompson was the first person with diabetes to be treated with insulin. It was a success as the boy was near death then quickly regained his appetite and strength. Other volunteers offered to test insulin and also reacted positively. In 1923, the Nobel Committee awarded Banting and MacLeod the Nobel Prize in Physiology or Medicine. The duo shared the cash award with Best and Collip.
• Soon after the discovery of insulin, medical firm Eli Lilly began a large-scale production of the extract. By 1923, they were producing significant amounts of insulin. While insulin is a treatment rather than a cure, it is considered one of the biggest medical discoveries. People with diabetes can live a normal life if they maintain regular insulin treatments.
• The discovery of insulin ultimately led to the development of protamine zinc in the 1930s. By 1950 the medical field discovered protamine Hagedom (NPH) insulin. In the 1980s, synthetic insulin became “human insulin.” Then the updated therapy was referred to as analogue insulin lispro by the late 1990s.
• A review of the history of insulin revealed the initial versions were impure. Over time, medical professionals found insulin, like other hormones, needs to bind to a receptor to do its work. Now they tend to use long-acting insulin, especially in outpatient settings, rather than regular insulin. An insulin pump is another way to ensure patients are getting the proper dosages throughout the day. This helps reduce the risk for hypoglycemia and weight gain associated with previous therapies.
• Medical professionals discovered early on that patients with type 1 diabetes must inject insulin several times a day. Some patients with type 2 diabetes also benefit from insulin when diabetes pills stop working.
• Continuous glucose monitoring is another cornerstone for patients with diabetes. Patients need to monitor their blood sugar levels at various times throughout the day and record the results. These records are shared with their healthcare team to look for patterns that should be addressed.
• Recent studies have revealed additional benefits of using insulin. It has been shown to exert an anti-inflammatory effect as well as limit platelet aggregation and expression of pro-thrombotic factors. Medical professionals are hopeful insulin is cardio-protective as heart disease and stroke can be complications related to diabetes.
• Despite concerns about the rising cost of insulin there will always be a need for this treatment. There are still types of available insulin which are low cost and may be substituted for newer ones. Never change your insulin type or dosage without consulting your health care provider. People using insulin experience fewer cases of renal disease, neurologic complications and digestive upset. Lifestyle changes can sometimes help people with type 2 diabetes and even eliminate the need for insulin. People with type 1 diabetes are dependent on insulin for their well-being.

The discovery of insulin almost a century ago has changed the quality of life for people with diabetes. Now people with diabetes can enjoy an active lifestyle with fewer complications. It is likely insulin will remain a long-term treatment for patients with diabetes.