Insulin against diabetes

The story

A disease with no cure

Diabetes is a disease in which the body cannot control the amount of sugar, glucose, in the blood. Normally, after a meal, the pancreas, an organ behind the stomach, makes a hormone called insulin, which lets sugar into the cells, where it is used as fuel. In type 1 diabetes, which mostly affects children and young people, the pancreas stops making insulin: the sugar stays in the blood and the cells are left without energy.

Before 1922 this disease was a death sentence. A child diagnosed with diabetes generally lived only a few weeks or months. People became thinner and weaker and more and more thirsty, and in the end they fell into a coma. The only known treatment was a very strict diet, almost starvation, which lengthened life a little but left patients skeletal. In hospitals there were wards full of desperately hungry children, struggling against hunger.

An idea in the night

In October 1920 a young Canadian surgeon in Toronto, Frederick Banting, had an idea while reading an article in a journal. Scientists knew that in the pancreas there are groups of special cells, the “islets”, which make a substance that regulates sugar, but when people tried to extract it, it was destroyed by the digestive juices of the same organ. Banting thought of tying off the ducts of the pancreas, so that the cells that make the juices would shut down and only the islets would stay active. He wrote the idea in a notebook, in the middle of the night.

In the spring and summer of 1921 he persuaded Professor John Macleod, at the University of Toronto, to lend him a laboratory for eight weeks, during his holidays, and an assistant, a twenty-two-year-old student, Charles Best. They worked with dogs. They extracted a substance from the pancreas and injected it into dogs that had been made diabetic: the amount of sugar in their blood went down, and the animals felt better. A little dog called Marjorie lived this way for weeks.

A fourteen-year-old boy

To make the treatment suitable for humans a purer substance was needed. An expert biochemist, James Collip, joined the group. On 11 January 1922, in the Toronto General Hospital, came the first test on a human being: Leonard Thompson, a fourteen-year-old boy, by now in his last days of life. The first injection was still too impure and had little effect, with a painful reaction. After Collip had improved the method, a second injection was given on 23 January: the amount of sugar in the blood dropped clearly and the boy began to feel better.

Soon other young patients were treated. In the wards where children lay almost in a coma, who no longer woke up, the injections brought them back to life within a few hours. Parents, nurses and doctors remembered those days as a miracle, as if it were a resurrection. Leonard lived another thirteen years. A young girl, Elizabeth Hughes, daughter of the American Secretary of State, who was treated in 1922, lived to the age of 73.

A gift to the world

In 1923 the Nobel Prize in Medicine was awarded to Banting and Macleod. Banting, angry that the committee had left out Best, shared his prize with him; Macleod did the same with Collip. The three scientists sold the patent to the University of Toronto for one dollar, so that the treatment would be available to everyone. A big American company, Eli Lilly, began to produce insulin in large quantities, extracting it from the pancreas of cattle and pigs.