History of Insulin - Part 1

I had the pleasure of visiting the NY Historical Society's exhibit on the history of insulin with my sister on December 21st.  After some holiday cheer I finally had the time to upload the pictures from the exhibit to my computer so over my next several posts I hope to walk you through how amazing the exhibit was.  The exhibit brought to light how incredible of a breakthrough the discovery of insulin was but also illuminated how the breakthrough would have saved far fewer lives had it not been for the potential profitability of the drug.  From a personal, medical and business perspective I was in awe as I walked through the exhibit.

Part 1 - The Breakthrough

In 1921 a group of University of Toronto researchers were able to isolate the peptide insulin from islet cells in the pancreas.  This would lead to the first partnership between a research university and a corporation, Eli Lilly.  The path to discovering insulin not surprisingly was met with in-fighting, and egos.  Tensions were no doubt raised due to the near death-sentence a diagnosis of type 1 diabetes had been met with to that point.

While the Toronto researchers were successfully isolating insulin in the pancreas Frederick Allen and Elliott Joslin were treating diabetic patients through a near starvation diet.  The idea was to restrict a diabetic to a critically low level of calories so that the body would be forced to accept the calories with a minimal insulin spike.  The diet prolonged the life of some diabetics but did not address lifestyle conditions and was not sustainable.  Essentially the diet bought time as the real treatment was being developed.

Dr. Banting in 1920 was reviewing an 1889 study of Dr. Minkowski and jotted the following note to himself "Ligate pancreatic ducts of the dog. Keep dogs alive till acini degenerate leaving islets. Try to isolate internal secretion of these and relieve glycosurea."  Over that summer Banting and team performed several experiments on dogs and were able to keep Alpha alive for the entire summer with no pancreas.  In subsequent months further tests were performed on dogs using insulin extracted from a fetal calf pancreas with positive results.  This led to the first human test on Leonard Thompson in 1922.  The first experiments proved costly as the insulin was too impure and caused severe allergic reactions in the test subjects.  With the help of Eli Lilly the research team was able to better purify the insulin extract which led to one of the most heart wrenching exhibits:

In 1922, 5-year-old Teddy Ryder was treated with insulin.  The first picture shows how dire his medical condition was prior to receiving insulin; the photograph on the right is Teddy after insulin a cherubic faced  healthy boy.  That moment more than any other during the exhibit struck me as how fortunate we all are that the Toronto based team was able to isolate insulin.  This team is the reason why any of us can function normally in society let alone run triathlons, compete in the NBA, NFL or accomplish whatever we set our minds to.

Teddy's note expresses in its simplest form the impact this discovery has had on anyone who has been diagnosed with diabetes:

"Dear Dr. Banting, I wish you could come to see me.  

I am a fat boy now and I feel fine.  

I can climb a tree.  

Margaret would like to see you.  Lots of love from Teddy Ryder."