So before 1920 children, young people who were
diagnosed with Type-1 Diabetes, had only days, weeks,
months to live. And very famous clinicians like Dr. Jocelyn in
the United States found ways to make these people live a little
longer, a few months, sometimes a few years, by treating them
with harsh diets avoiding carbohydrate intake, for
instance, they were called ketogenic diets. And by doing
that people survived, they didn't really live, they just survived,
they lost all their weight, all their muscle, all their fat
tissue. And so it was really a very, very grim prognosis before
the discovery of insulin.
In 1921, it was like different things came together in a very
lucky way with on the one hand, an orthopedic surgeon returning
from the war, Frederick Banting, who wanted to do research, who
contacted Professor McCleod at the University of Toronto
interested in physiology. And so McLeod gave Banting, some lab
space and also allocated a student to him, Charles best.
And he asked him to work on these pancreatic extracts, they
started working on dogs. And what they showed is indeed that
if they made extracts from pancreas, they could treat
pancreatectomised dogs and keep them alive. However, their
extracts were impure. And that is where everything came
together when they met Dr. Collip, who was a pharmacist,
who was able to develop a method to make purified extracts this
time, not from dogs, but from cow pancreases from the
slaughterhouse. And so it was at the end of 1921, that Collip
was certain that his extract was pure enough to allow experiments
in humans. And so it was on the 10th of January 1922, that a
young boy Leonard Thompson, who was a 14 year old child dying
from diabetes, was treated with insulin for the first time in
Toronto hospital. Very soon, the University of Toronto also
realized that they couldn't really manufacture the
amounts of insulin that were needed to treat all the people
living with diabetes and desperate to get their hands on
this miracle drug. And so they started to collaborate with
industry, like the Connought Laboratories, and then soon
after, with other bigger pharmaceutical companies, not
only in North America, but also very soon in Europe. Very
soon, people started altering the nature of the insulin they
were using to treat patients with diabetes. The first thing
they tried was to make the need for injections of insulin every
four to six hours less. And so they tried to make the insulin
longer-acting. And some of my colleagues call that 'the dark
ages of insulin treatment' in people with diabetes, because
treating them only with a very long-acting insulin took us even
further from the physiology of what the beta cell makes as an
insulin profile. And so in the 40s, 50s, 60s, 70s - people being
treated with just one or two injections of insulin per day,
meant that their glucose levels were not well controlled at all.
And so what we discovered is that bad glucose control led to
severe long-term complications of diabetes, like blindness,
like kidney failure, and heart problems. The hunt for
manufacturing different types of insulin, pure insulins, less
immunogenic insulins was really aided by the whole genetic
engineering of bacteria and yeast. And therefore, these new
analogues that we're now using is really the fruit of all of
that discovery. The exciting bit about the celebration of insulin
is that the party is not over yet. Indeed, we are still
discovering new forms of insulin. We're now at the
beginning of being able to use oral insulin. We're seeing
glucose sensitive acting insulins we're seeing liver
preferred insulin. So, research on insulin is extremely active,
but honestly, I hope we can stop researching insulin quite soon,
and that we may find better ways to treat people with type two
diabetes, and that we can finally prevent
and cure Type-1 Diabetes.