100 Years of Insulin
How a Groundbreaking Discovery Transformed Diabetes Care
My grandfather, Dr. Randall Sprague, weighed just 78 pounds as a teenager. He sat alone on the front porch swing — starving himself to manage his disease — while his family ate dinner inside. In September of 1922, his doctor admitted him to Presbyterian Hospital in Chicago and did not expect him to live. He had Type 1 diabetes and became one of the first test patients when insulin was introduced.
Before the discovery of insulin, the diabetes treatment was a starvation diet. In the early 1920s, Dr. Frederick Allen developed a restrictive diet that eliminated all carbohydrates to reduce glucosuria, or sugar in the urine. In most cases, diabetic patients on Dr. Allen’s diet were held to 450 calories a day. If they returned to their former diets, they died shortly afterward. Patients who complied with Dr. Allen’s restrictive program lived longer but eventually died of starvation.
In other words, 100 years ago, a diabetes diagnosis was effectively a death sentence.
A Medical Miracle Discovered
The discovery of insulin is attributed to Dr. Frederick Banting, a Canadian physician, and Dr. Charles Best, a medical student. Their groundbreaking research at the University of Toronto in 1921 led to the isolation of insulin from the pancreas of dogs, providing a life-saving treatment for diabetes. This discovery revolutionized diabetes management, transforming it from a terminal condition to a manageable one through administering insulin, a hormone critical for regulating blood sugar.
While Dr. Banting and Dr. Best’s work earned them a Nobel Prize in Physiology or Medicine in 1923, it is worth noting that Dr. John Macleod and Dr. James Collip also played essential roles in insulin development and commercial production.
Deploying the Remedy
On September 21, 1922, the day before his 16th birthday, my grandfather received insulin for the first time. After being on insulin for one week, he experienced a severe anaphylactic reaction with symptoms that persisted for two days, including skin eruption, nausea, vomiting, a drop in blood pressure, and profound weakness.
He later learned that the extract he received was full of “foreign protein,” so the insulin was discontinued for six days, and his condition deteriorated further. His doctor sent a telegram directly to Eli Lilly requesting additional life-saving doses of purified insulin. Within weeks, he received a new batch and his blood sugar stabilized.[1]
My grandfather took more than 50,000 doses of insulin by the time he died at 84. As a young man, he received his MD from Northwestern University in Chicago and became a distinguished endocrinologist at the Mayo Clinic in Rochester, MN. He authored or co-authored more than 130 articles on diabetes, and I was proud to learn that he served as President of the American Diabetes Association in the early 1950s.
He was a tireless advocate who dedicated his life to treating people with the complicated disease he knew so well.
The Modern Situation
The prevalence of diabetes has been on the rise in the U.S. for decades.
According to the CDC, 37 million — one in ten — Americans have type 1 or type 2 diabetes, and that number is expected to double by 2050. Treatment options for diabetes have come a long way since 1922, thanks to the evolution of technology. Continuous glucose monitoring (CGM) devices, insulin pumps, and patches provide real-time data and insulin delivery. Mobile apps and wearable devices help track food intake and physical activity and provide medication reminders. Advancements from companies such as Medtronic, Abbott, and Dexcom continue to push the boundaries of technology to help ease the burden of living with diabetes in the 21st century.
In 1965, my grandfather wrote an article for the American Diabetes Association: Diabetes — Past, Present, and Future. In that article he imagined a world with automated insulin delivery that would “become available to the body in accord with metabolic needs.” I think he would be pleased at the incredible technological advances that offer more personalized and convenient ways to monitor and control diabetes and insulin delivery, improving the overall quality of life for those with this chronic, complex condition.
In my lifetime, I am hopeful we will find a way to end the diabetes epidemic entirely.
[1] Bliss, Michael, “The Discovery of Insulin,” The University of Chicago Press, 1982, 2007, page 159.
Photo by Mykenzie Johnson on Unsplash
