March 28, 2023

2021 marks 100 years since the discovery of #insulin. Watch our #EASD2021 mini-documentary to learn more about the history of this discovery, which has saved the lives of millions of #pwd. #diabetes #t1d #T2D #insulin100

Behind me is london’s charter house a hospital built in the 14th century at the time of the black death now everyone assumes that plague is lethal but in fact even back then one in five people survived by contrast everyone who developed diabetes died from it and that situation continued right up until the beginning of the 20th century but then 100 years ago

Two researchers in canada changed everything this is the story of the groundbreaking discovery of insulin tilly tanzi is professor of the history of medicine working at queen mary university which stands on the site of the charter house so bunting and best didn’t come out of nowhere they were building on research and knowledge that was already available in the

Medical world but nobody had really sort of put it together or made that great step of doing a key experiment banding and best might have been standing on the shoulders of giants but neither had any background in research one was a country surgeon the other a medical student daniel drucker is a senior scientist at the mount sinai hospital in toronto birthplace of

Insulin so benti was our most unlikely heroes he thought he had a famous dream that we’re all familiar with and he wrote got up and wrote down on a piece of paper that if he could ligate the ducks of the pancreas and isolate the pancreas and purify this mysterious hormone that might be the key to unlocking the puzzle remarkably he managed to persuade the chair

Of biochemistry who was jjr mccloud a famous biochemist and can you imagine today an orthopedic surgeon from a small clinical medical school walking into the big city and asking for resources and money and staff and space to do these kind of experiments and today you’d think they would call security and have this person escorted to the curb uh yet macleod was

Persuaded banti must have been charismatic gave him lab space assistance like charlie best and there they went in the summer of 1921 and the rest is history of course the very first patient was a young boy called leonard thompson who was dying of diabetes in toronto children’s hospital and banting and best with macleod and the chemist who had been recruited

Into the team james collip had a preparation of insulin that they decided to try to inject into this patient and it was not true failure leonard thompson got this massive abscess in his leg so you know half of his thigh became infected and if that happened today the drug regulatory authorities would have put what we call the clinical hold and they would have

Stopped all treatment but what happened in 1922 was that you know they were allowed to go back to the lab and call up who was the talented biochemist on the team he worked his magic to purify the extract and the next injection worked and the infection was no longer a problem and off they went the good news spread fast with patients worldwide wanting treatment

One was elizabeth hughes elizabeth hughes was one of the earliest patients of bunting and bests and she was the daughter of an american diplomat she was about i think 12 when she was first given insulin she was a death store the only treatment for diabetes at that stage was to reduce carbohydrate intake so she’s effectively starving to death as diabetics did

In those days she was given insulin she responded very well to the treatment and she lived until i think she was nearly 80. it was reckoned that she’d lived she’d had about 45 000 injections during her life for elizabeth there was a happy outcome but back in toronto it was the beginning of a pr nightmare you go from the euphoria of the discovery to the hundreds

Of letters and telegrams that are arriving daily and one quickly realizes from banting to the university of toronto that’s formed a special insulin committee that oh my goodness we are going to be in a big you know problematic space if we have to tell the world i’m really sorry we can only treat five percent of you in 1921 there were very few companies around

The world with any kind of industrial capability everyone that could jumped onto the bandwagon to try to make insulin they mainly developed different techniques different measuring techniques different standardization techniques so it’s a very confused area and actually finding the pancreas from which you could develop the insulin and eventually most producers

Settled on cattle some manufacturers claimed that it took a thousand cattle to make a dose of insulin the railroad tracks in indianapolis were designed to go right into the sort of established abattoir laboratory because they had such a huge need that we relied on beef and pork insulin really up until the early 1980s when recombinant dna technology came to

The rescue and we had recombinant human insulin production wasn’t the only battlefront cost and access was an issue from the beginning as it still is today banting had a very clear view so let’s not let profit stand in the way of our ethical obligation to treat the world’s population living with type 1 diabetes one of the companies that became very important

In insulin manufacture was a danish company novo no disc so the university of toronto sold the insulin patent for a dollar in europe the league of nations got involved with insistence that companies make minimal profit back in canada things got ugly when the 1923 nobel prize went to just two of the four people involved why did they not pick a third individual

So best was the medical student who won the coin toss to work with banting that summer obviously instrumental but most of us recognize that colin the biochemist from alberta on sabbatical working at the university of toronto was essential to the purification and development of insulin as a medicine the discovery of insulin was of enormous significance in the

History of diabetes but how does it compare with other medical discoveries in many ways insulin epitomizes medical research in the 20th century obviously the priorities disputes and the personalities we all know about but that it really came to the fore very much in the 20th century especially with the law of the nobel prize it also is a very important in the

Point of translation of a lab research project into commercial production and that brings in a whole load of issues such as obviously machinery specialized stuff production facilities supplies but also marketing packaging preservation and also for the patient how you actually get the drug insulin revolutionized how patients dealt with disease because patients

Injected injections were really known as something that cocaine addicts used were not used routinely in medical therapy and only then is something that a doctor did to a patient so a patient injecting themselves was really revolutionary and the patient taking control of their own disease you

Transcribed from video
100 years of Insulin By European Association for the Study of Diabetes