in soCiety NINETY YEARS of – Canada celebrates

Marc Aras

Banting and Best showed their results The discovery of insulin in 1921 is undoubtedly one of the most to Macleod and excitement began to significant medical discoveries of the 20th century. frederick grow around their work. A young chem- Banting is considered as the main discoverer since he was the ist, James Collip, was appointed to help one who had the idea of tying a ligature round the pancreatic them prepare pancreas extracts. The first articles from that research were canals in order to provoke diabetes. when he was still a young published at the end of 1921. surgeon in London, ontario (Canada), he met JJr Macleod of the University of and suggested experimenting On the 11 , the first injec- with this procedure in dogs. Not entirely convinced, professor tion of an extract was given to 14-year- Macleod provided him with the necessary research laboratory old insulin pioneer Leonard Thomson. According to the doctor who gave him and offered the services of a young science student, Charles that injection, the thick liquid was a Best. They started their experiments during the summer of brownish colour, which clearly indi- 1921. The dogs indeed developed diabetes. The pair then tested cates the presence of other substances. various pancreas extracts in order to – or so they hoped – cure Analyses were carried the following day: Leonard’s glycaemia dropped from 24.5 the diabetes. After numerous trials, they managed to stabilize mmol/L to 17.8 mmol/L. A relatively the glycaemia of one of their guinea pigs. Marc Aras takes up large amount of glucose was still passing the story of a truly great Canadian achievement. through his urine and this first trial was considered a ‘semi-failure’.

Macleod and Collip were not aware of the intentions of Banting and Best; they were surprised and upset at having been kept unaware of these developments. Collip believed he could produce purer insulin and told Banting and Best that they should have waited before experi- menting on people.

April 2012 • Volume 57 • Issue 1 DiabetesVoice 41 DIAbetes IN sOCIetY

Different types of insulin have since been developed – the fast- and slower- The extract was then called ‘isletin’; acting . In the 1970s, the first only in April 1922 did it receive human insulins were developed, not from human pancreas but by chemical the familiar name insulin. manipulation of animal insulins and by genetic engineering of yeast and bacteria. Gene modification produced the rapid- Only on 23 January, 12 days after the In February 1922, six young people acting analogue insulin in the 1990s and first injection, Collip resumed the ex- with diabetes received insulin extract flatter long acting insulins a little later. perimental treatment with Thomson. with the same positive results. At that Research is still underway to develop This time, the success was complete; time, the extract was then called ‘isletin’; other types of insulins that might help his glycaemia dropped from 28.9 to only in April 1922 did it receive its final, people achieve better control. 6.7mmol/L. Nearly no sugar is passed now familiar, name – from the English Today, more than through into the urine. Over the next physiologist Sir Edward Albert Sharpey- couple of days, when Leonard did not Schafer. The breakthrough in February 30 million people receive any of the insulin extract, his gly- had made the headlines. Macleod’s labo- worldwide live caemia rose again. During the following ratory began preparing larger amounts thanks to insulin. weeks, he received the daily injections of insulin in response to overwhelm- that helped him gain weight and recover ing demands. The US-based Eli Lilly Last year, the first person to have lived some strength. Company was approached to produce on insulin for 85 years was celebrated insulin in industrial quantities. In 1923, in the USA. Bob Krause, a 90-year-old insulin made from ox pancreas – and retired engineer was born in the year later from pigs – was made available to insulin was discovered! large numbers of people with diabetes. The Bank of Canada announced on At the end of 1923, Banting and Macleod World Diabetes Day, 14 November, 2011 received the Nobel Prize for their dis- the release of a new CAD100 bill made covery. They shared this Prize with their of a special resistant material, com- two fellow researchers. memorating the discovery of insulin. If Banting were working The world-famous Canadian medical achievement is portrayed on the reverse today, at least 10 years of the bank note, where an insulin vial would be needed for illustrates that historic breakthrough. insulin to be approved.

Perhaps the most astonishing part of this discovery is the speed with which they moved from animal testing to commer- cialization. In comparison, if Banting were working today, at least 10 years would be needed for insulin to be approved! The protocols for research and the consent of people, like Leonard Thomson, un- dergoing an experiment are much stricter nowadays, and must be passed by an eth- marc Aras ics committee. The speedy processes of Marc Aras is the communication director of Diabète Québec. yesteryear saved many lives.

42 DiabetesVoice April 2012 • Volume 57 • Issue 1