Diabetes: How far have we come? How far have we to go?

To mark Disability History Month, members of EEAST’s Disability Support Network have been looking into the history of their own disabilities. Today, the networks secretary Mandy Harris is here to talk about Diabetes. 

Diabetes has been around for thousands of years; possibly in a medical text from around 1550 BC and regularly referred to throughout history. Diabetes Melitus and Diabetes Insipidus were distinguished by J P Frank in 1794. Von Mering & Minkowski were credited in 1889 with the formal discovery of the role of the pancreas and in 1893 Laguesse suggested cells in the pancreas, Islets of Langerhans (named after the discoverer in 1869) could play a regulatory role in digestion. Physicians in the early 20th century hypothesized that the islets secreted Insulin to metabolises carbohydrates.

In 1920, Sir Frederick Banting (a Canadian surgeon not scientist) realised after reading an article, that in theory, breaking down the pancreas in a certain way would leave production cells intact and enable insulin to be extracted. He met with John Macleod at the University of Toronto to work on a plan. Labs were supplied by Macleod and research student Charles Best was brought in. 

May 1921, Banting, Best and Macleod began research using dog’s, the aim was to kill off other substances in the pancreas that would destroy insulin but leave the islets intact. The substance extracted was given to dogs whose pancreases had been removed to work out its effects on blood sugar levels. By November 1921, the first experiments were successful in treating a dog with diabetes for 70 days with the extract insulin. 

December 1921 saw the addition of James Collip, a biochemist, who worked on concentrating and purifying insulin developed from cattle pancreases, ensuring it was safe to be tested in humans.

In January 1922, insulin was first used to treat diabetes. Leonard Thompson, a 14yr old boy dying from type 1 diabetes received the first human injection of insulin. Within 24 hours, his dangerously high blood sugar levels dropped. Unfortunately, an abscess developed at the injection site; Collip worked day and night further purifying the extract. A second dose was given successfully, Leonard’s blood sugar levels dropped to near-normal, no obvious side effects were seen. Type 1 diabetes was no longer a death sentence.

Insulin went into mass production in May 1922 and in October 1923 Banting and Macleod were jointly awarded the Nobel Prize in Physiology of Medicine. They each split his half of the Prize money with Best and Collip.

The Diabetic Association (Diabetes UK, 2000) was founded in 1934 by HG Wells and Dr RD Lawrence; both had type 1 diabetes. Their mission statement "to promote the study, the diffusion of knowledge, and the proper treatment of diabetes in this country". Diabetes UK have made more life-changing discoveries. Transforming the delivery of insulin by funding the first ever insulin pen and insulin pump thereby making living with Diabetes dramatically simpler. They are helping prevent sight loss with the roll out of national eye screening programmes. Reducing amputations by setting up the first diabetes foot clinic in the UK and using the DiRECT trial to put type 2 diabetes into remission.

2021 will be the 100th anniversary of the discovery and purification of insulin by Banting, Macleod, Best and Collip. It is one of the greatest medical breakthroughs in history, which has saved millions of lives around the world.

Published 17th December 2020