30
LIVING
Look back in hanger?
Insulin - the first 100 years. Until the discovery and
refinement of this life-saving, life-changing hormone,
anyone with "sweet urine disease" slowly withered
away. Medical journalist and health writer Susannah
Hickling takes a look at what happened in Canada in
January 1922.
Hangry is a term some people use about the
'feed me!' response to having a low blood sugar;
hypos make you hungry, and you can be quite
angry about it too. But until a momentous
day 100 years ago no one with diabetes ever got hangry
because of too much insulin - they just died.
Then one January day in 1922 the world changed
for people with diabetes. Fourteen-year-old Leonard
Thompson, emaciated and close to death when his father
brought him into Toronto General Hospital, Canada,
became the first human being to receive a shot of insulin.
In spite of an initial nasty allergic reaction at the site
of the injection from an extract derived from mashed-up
cow pancreas, his blood glucose levels dropped. By the
time he received a second shot two weeks later, scientists
had worked hard to remove impurities in the raw
pancreas extract. Not only was there no recurrence of the
abscesses, but there was a remarkable improvement in
Leonard's health. He continued taking insulin and went on
to live a further 13 years, dying of pneumonia at the age
of 26.
Previously, a diagnosis of Type 1 diabetes was a
death sentence. It was far from being a new condition
- diabetes was first described in ancient Egyptian
manuscripts dating to around 1500 BC - but no one knew
what caused it or how to treat it. As late as the beginning
of the twentieth century in pre-insulin days, doctors
were prescribing a starvation diet, so if the diabetic
ketoacidosis (DKA) didn't get you, the lack of food would.
Once diagnosed, people were lucky if they lived more
than a few months.
In 1889, Strasbourg physicians Joseph von Mering and
Oskar Minkowski localised the cause as being linked to
the pancreas - a deduction made on the basis of dogs
becoming sick and dying after this organ was removed -
and then in 1910, British physiologist Sir Edward Albert
Sharpey-Schafer realised that one key chemical was
absent from the pancreas of people with diabetes. He
called this missing chemical "insulin", after the Latin word
for island, "insula", in reference to the island-like clusters
of cells in the pancreas, the islets of Langerhans, which
produced it. These had been discovered by a medical
student of the same name in 1869.
No man is an island
Scientists worked out that these cells were destroyed
in Type 1 diabetes. It was also theorised that insulin
controlled the metabolism of blood glucose, and that a
Banting, Best and dog.