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Today in history… lifesaving first for type 1 diabetes

12:00am | & Lifestyle

TODAY it is estimated that around 400,000 people in the UK live with type 1 diabetes, managing their condition with regular insulin injections, but just less than a century ago a diagnosis with the condition was effectively a death sentence.

It was 97 years ago today, on January 23rd, 1922, that a Canadian teenager became the first diabetic patient to receive an insulin injection to treat his condition. After some initial side-effects, he reacted positively and his health showed a remarkable improvement, leading to further research which has since saved millions of lives.

Diabetes had been recognised as a distinct medical condition for more than 3,000 years, but its exact cause remained a mystery until the 1920s. Prior to that, a diagnosis with type 1 diabetes was a death sentence, with those affected usually dying within months and sometimes within weeks or even days. It was particularly distressing as most children with diabetes have type 1.

The only way to alleviate the symptoms of type 1 diabetes was through a diet low in carbohydrates and sugars and high in fat and protein, but it only brought a temporary reprieve. Instead of patients dying soon after diagnosis, they could hope to live for about a year.

Medical researchers at the University of Toronto made a crucial breakthrough in the summer of 1921. Carrying out experiments on laboratory animals, Canadians Frederick Banting and Charles Best isolated a particular protein which was secreted from the pancreas – a large gland deep in the abdomen. If they removed that protein – called ‘insulin’ – from the test animals, they began to exhibit the symptoms of diabetes.

Banting and Best theorised that people with type 1 diabetes were producing very little or no insulin from their pancreases, which resulted in the very high blood sugar levels which would eventually kill them. They believed that injecting insulin from another source could mimic the function of the patient’s defective pancreas and thereby alleviate their condition.

Theorising was one thing, but proving it was another, which is where 14-year-old type 1 diabetic Leonard Thompson entered the story. His parents, realising they would soon lose their son, agreed to Leonard undergoing an experimental injection of insulin extracted from the pancreases of cattle, collected from local slaughterhouses.

The first injection, administered in Toronto 97 years ago today, caused a severe allergic reaction in Leonard, probably due to an impurity in the insulin, but some of his diabetes symptoms still improved. Another member of the Toronto research group, James Collip, was brought in to develop a way of purifying the harvested insulin ready for injection. Leonard was given a second injection 12 days after the first, now using purified canine insulin, which more closely resembled the human variety.

This time there was no allergic reaction and Leonard’s health improved quickly and dramatically. The insulin injection was doing its work, imitating the function of Leonard’s pancreas and stabilising his blood sugar level. Further research quickly established how to accurately monitor a diabetic’s blood sugar and the correct doses of insulin needed to stabilise it.

By 1923 insulin was becoming widely available to treat type 1 diabetes in the developed world, turning what had been a terminal illness into a manageable condition with a greatly improved prognosis. Banting, Best and Collip shared the patent for insulin, which could have made them very rich indeed. Instead they sold it to the University of Toronto for one dollar, so that the financial rewards could fund further research and development there.

Leonard Thompson lived for another 13 years, his expected lifespan almost doubled through taking regular doses of insulin. He eventually died of pneumonia at the age of 27. Today, millions of people worldwide use insulin to treat and manage their type 1 diabetes. Modern insulin is synthesised from human insulin, as this ‘biosynthetic human insulin’ is much purer than that extracted from animals.

Type 1 diabetes – in which the body’s own immune system destroys the cells that produce insulin – is much rarer than type 2, in which the body doesn’t produce enough insulin or the body’s cells don’t react to it. Type 2 diabetes accounts for about 90% of UK cases and can often be treated and sometimes reversed through medication combined with lifestyle changes such as diet and exercise. To find out more about diabetes, including types and symptoms, click here.

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