How insulin was invented

In the history of mankind, not many drugs have been invented that have dramatically changed people’s lives, but they are very important. Let’s name them. They are acetylsalicylic acid or aspirin, a monument to which is erected in Germany, antibiotics, which stopped large-scale infectious epidemics, and insulin. To begin with, let us tell you a story.

Early twenties of the twentieth century.
Ten-year-old Geneva Stickelberger from the American town of Oberon, North Dakota became ill: she began to drink a lot, often went “pee-pee”, quickly lost weight. Doctors had seen this disease in other people before, but they did not know how to treat it.
Geneva’s condition was worsening, and her mother could not accept the fact that she was losing her daughter, and persistently searched for scientists who could save Geneva. At the same time, news of an amazing drug discovered by Canadian physician Frederick Bunting and medical student Charles Best, who assisted him, began to spread around the world. Thousands of letters began pouring in to the Canadian scientists begging them to save children with a similar disease.

In the summer of 1922, Geneva’s mother also became aware of the miracle cure. She called Banting, who immediately summoned the sick woman to his office. On the train, the girl became ill, she fell into a coma. The driver called an ambulance to the arrival of the train. Bunting was also informed of Geneva’s fatally deteriorating condition. The young scientist met the patient at the train station and gave her an injection of the drug there. The doomed girl regained consciousness, and gradually her well-being began to improve.

Geneva lived a long active life and died at age 72. From the time of the first injection she was constantly treated with the miraculous drug for 61 years.
You may have guessed that Geneva was a diabetic, and only through the discovery of insulin did she have a chance to compensate for her disease and live a full life.

The physiological essence of this disease is complex: in order for the body’s cells to absorb sugar from the blood, thus carrying out nutrition, they need the hormone insulin, which is produced by special cells of the pancreas. When you have diabetes, insulin is no longer produced or not produced enough. As a result, when there is an abundance of food, the cells starve and the sugar is excreted from the body with the urine.

In the past, before tests were used to detect sugar in the urine, the diagnosis of diabetes in men was made by flies. They would swirl at the bottom of his pants, on which sweet drops of urine would accidentally fall when a man went to the bathroom.
“Sugar sickness” has been known since ancient times, as far back as the third millennium B.C. This diagnosis was a death sentence for the patient until the late 19th century, when studies of the pancreas were initiated and the first step toward understanding the causes of diabetes mellitus was taken. Even before that, the science of the glands of internal secretion, called endocrinology, had emerged.

In 1869, a German anatomist and histologist Paul Langerhans, then a 22-year-old student, discovered specific groups of cells in the pancreas, which would later be called “Langerhans islets” in his honor. A few years later, it was from these islets that the hormone insulin would be isolated. But this great event was preceded by a series of scientific studies.

In 1889, German clinicians and physiologists Oskar Minkowski and Josef von Mering demonstrated in animal experiments that removal of the pancreas leads to the development of diabetes. But when the same animals are injected with an extract from the pancreas, the symptoms of diabetes disappear. Thus, it was established that the pancreas somehow controls blood sugar levels, but how exactly this occurs has yet to be elucidated.

In 1900, pathologist Leonid Vasilievich Sobolev studied the structure and function of the islets of Langerhans, experimentally proving that it is these areas of the pancreas that carry out specific internal secretion, regulating blood sugar levels.
At the beginning of the twentieth century, scientists and physicians came so close to discovering insulin that it occurred almost simultaneously in several countries. Approximately six months before the Canadian discovery of insulin became known, the hormone was isolated in the laboratory by the Romanian professor of physiology, Nicola Paulesco. But due to language difficulties in post-war Europe, the world learned about Paulesco’s discovery later than Canadian scientists. Therefore, Bunting and Best are considered to be the discoverers of insulin.

At the beginning of the twentieth century, scientists and physicians came so close to discovering insulin that it occurred almost simultaneously in several countries. Approximately six months before the Canadian discovery of insulin became known, the hormone had been isolated in the laboratory by the Romanian professor of physiology, Nicola Paulesco. But due to language difficulties in post-war Europe, the world learned about Paulesco’s discovery later than Canadian scientists. Therefore, Bunting and Best are considered to be the discoverers of insulin.

So, in the summer of 1921, two young Canadian scientists – surgeon Frederick Bunting and his assistant Charles Best – in the laboratory of Professor John McLeod of the University of Toronto isolated from an extract of the pancreas of a dog and then a calf a substance, which is called “ailetin”.

It was aylethin, which McLeod later proposed to be renamed “insulin” (from the Latin insula – islet), that became the long-awaited and miraculous drug for the treatment of diabetes, and those suffering from it gained the right to life.

The first patient to receive an injection of insulin was a fourteen-year-old Toronto clinic patient, Leonard Thompson. Unfortunately, the drug was not sufficiently purified: a severe allergic reaction began, and, despite a decrease in Leonard’s blood sugar concentration, the injections were stopped. After 12 days, during which the biochemist Colin worked hard to improve the extract, insulin was injected again into the same patient. This happened on January 23, 1922. This time the success was overwhelming, the disease stopped progressing, there were no side effects, and the dying boy went on the mend.

The next patient was Banting’s close friend, physician Joe Gill-Crista. His cure finally confirmed that a cure had finally been obtained to save hundreds of thousands of lives! For this discovery, Frederick Banting and Professor MacLeod already received the Nobel Prize “for the discovery of insulin” in 1923. Bunting, recognizing the merit of his assistant Charles Best, gave him half of his prize, and now in the history of medicine their names stand side by side.

That same year, 1923, Bunting met Colonel Eli Lilly, founder of the Lilly pharmaceutical company. The company immediately set out to develop mass production technology for insulin, and it saved the lives of many diabetic patients. Adjustment of production was surprisingly fast: already in spring of 1923, equipment for mass production of the drug was put into operation.

On October 15, 1923, animal insulin Iletin was released. By the end of 1923, Lilly produced nearly 60 million units of the drug – and the era of insulin in the treatment of diabetes began.

This fatal disease was no longer a death sentence. By taking insulin and controlling blood sugar levels, people diagnosed with diabetes can lead an almost healthy lifestyle.

In 1948, Elliot Proctor Joslin, an American endocrinologist, established a medal that was given to those who had lived with a diagnosis of diabetes for 25 years. In 1970, however, the medal was discontinued: after all, thanks to insulin, longevity with diabetes had become a mass phenomenon. Instead, a new medal was established, which began to be awarded to diabetics who lived with the disease for more than 50 years. Its front side shows a man with a torch and the inscription: “Triumph for Man and Medicine”, on the back – “For 50 Courageous Years with Diabetes”.

The chemical structure of human insulin was established in 1960. Using the method of genetic engineering, the complete synthesis of human insulin was carried out for the first time in 1976. Currently, diabetic patients are treated only with human insulin and its synthetic analogues. Insulins of animal origin are no longer used.

The chemical formula for insulin answers the question of why, until now, insulin can only be taken by injection. The fact is that insulin is a protein. It is digested in the gastrointestinal tract, not getting into the bloodstream where it is supposed to work.

Insulin is always needed in type I diabetes, when the secreting cells die as a result of an autoimmune attack. It is also used in many cases of type II diabetes when insulin is insufficient. With the advent of syringe pens and blood sugar test strips, the quality of life for diabetic patients has increased many times over, but they still have to count bread units, determine sugar levels, make calculations and give themselves insulin injections.

Science has come close to automating this process. There is already a device like a patch with a micro-needle: it is glued to the shoulder, performs all these procedures automatically and simulates the work of the Langerhans islets in the pancreas.