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The real story of insulin and my diagnosis with type 1 diabetes at age 42

As the discovery of insulin marks it centenary, Diabetes UK member, Kersten Hall, explains why personally he has good reasons to be grateful and what led him to write his book about the story of insulin.

As the colour of the glucose test strip began to change, so too did the expression on my doctor’s face. Gentle concern quickly intensified. Picking up the phone, he made an appointment for me at St. James’ Hospital and ordered me to go there immediately.

The warning signs had begun a few weeks earlier when I’d noticed that I’d been becoming increasingly grumpy and lethargic. With my 42nd birthday not far off, my first response was to shrug this off as being nothing more sinister than the usual traits of any middle-aged man. But the onset of some new symptoms set alarm bells ringing. With a sudden ravenous craving for sugary drinks, an incessant need to go to the toilet, and rapid weight loss, I started to recall some vague memories of a lecture course in metabolic disease when I’d studied Biochemistry at university. And that first gave me a hunch of what might have been wrong.

My trip to St. James’ Hospital confirmed those suspicions. Having tested the concentration of sugar in my blood and found it to be a 33mM, a young doctor informed me that I had quite suddenly developed type 1 diabetes – a condition with which, as one GP later explained to me, ‘there are no holidays’.

A life-changing diagnosis 

Receiving a life-changing diagnosis as happened to me can be very unsettling and leave you feeling vulnerable and lonely – and it’s important to find positive ways of managing those feelings. The DAFNE course which I attended shortly after being diagnosed was invaluable in what it taught me about insulin and diet, but it also gave me a very welcome sense of solidarity and camaraderie with my fellow patients on the course. But immersing myself in researching the story of insulin proved to be another positive way in which I was able to deal with the psychological impact of the diagnosis. As I explained in a talk to some Year 12 and 13 students recently, life won’t always work out how you expect it to, hope it will, or think it should but when life does throw a challenge at you, try to see whether it can be used as an opportunity.  Or, as a recent edition of Balance magazine put it - when life hands you a lemon, the best course of action is to make lemonade

Thanks to insulin, people living with diabetes are now able to live well. And as my life was now going to be dependent on daily injections of this stuff, I wanted to know more about its story. In my day job as a historian of science, I’d often dug into the stories of people whose crucial contributions to major scientific landmarks have been overlooked, but after my own diabetes diagnosis, my professional interest in this subject had suddenly become very personal.

The story of insulin

What I found was a drama driven by characters who often had huge but brittle egos, bitter career rivalry, and were hungry for fame. Some of them took credit for work they didn’t do while others toiled away only to be overlooked, and at times it reminded me of ‘Game of Thrones’ - only enacted in lab coats and pipettes rather than chain mail and poisoned daggers.

But does any of this really matter? Does anyone really care who discovered insulin – as long as someone did, and we can use it to manage our diabetes?

I think the stories do matter. When I first began writing my book, it was a form of therapy – a way of coming to terms with the shock of the diagnosis and the negative feelings that followed. But with the onset of the coronavirus pandemic, I wondered whether the story of insulin might have broader lessons for us all about what technology can – and maybe more importantly, can’t do for us.

The first newspaper headlines to report on the treatment of patients with insulin in early 1922 were quick to hail it as a miracle cure for type 1 diabetes. But the clinicians involved in these trials knew that it was nothing of the sort. But they were quick to recognise that insulin, while not capable of curing diabetes, did change a fatal condition into one that could be managed.

After living with type 1 diabetes for just over ten years now, I think I can appreciate what insulin can and can’t do. Injecting myself several times a day will certainly allow me to live with type 1 diabetes, but to live well with this condition and avoid complications requires something extra. It requires me to be  be playing my part by thinking carefully about what I’m eating and what activity I’m doing.

Lessons for the future

I think there’s a lesson here for other challenges that we’re currently facing, such as climate change, artificial intelligence or global pandemics. Tempting as it may be to hope that technology alone will solve these problems, I suspect the truth is that we’ll have a better chance of dealing with them only if technological solutions go hand in hand with changes in our behaviour.

There’s another reason why the story of insulin matters too. With talk of PCR, mRNA vaccines and R numbers on our TV each night for the past two years, we’ve all become acutely aware of the impact that science has on our everyday lives. Very often we think of scientific discoveries as having been made by geniuses who stand on each other’s shoulders to tower above the rest of us and shout ‘Eureka!’. But what I’ve found in researching the insulin story is a very different picture. Take Fred Banting for instance who, when he was first told that he had been awarded the 1923 Nobel Prize for the discovery of insulin, reacted not with delight – but with fury. And, depressed by fears that others might steal his glory for this discovery, he resorted to stealing alcohol from his lab, admitting ‘I do not think that there was one night during the month of March 1922 that I went to bed sober.’

Insulin, now relied upon by me and millions of other people living with diabetes, was discovered not by towering geniuses shouting ‘Eureka!’, but rather by a cast of characters, like Banting, who had flaws and virtues just like the rest of us. The path they trod to find insulin was a crooked and meandering one, and maybe that’s what makes their achievement all the more impressive.

Kersten Hall - Author

Before turning to writing about scientific discoveries, Kersten worked as a molecular biologist in biomedical research for several years and he thinks that this background did help in thinking about his diabetes. But a far greater help (alongside insulin) has been the recent development of continuous glucose monitoring systems. He enjoys that he doesn’t have any more awkward moments of having to covertly prick his finger and take a reading under the table when out for a meal. He is also relieved at no longer having to struggle to prevent test strips from blowing away in a crosswind when attempting a blood sugar test at the summit of Helvellyn. And his kids think it’s quite cool that their Dad is now a cyborg.

His book about insulin, Insulin - The Crooked Timber, is out now.

The views and opinions expressed in the ‘views’ section of this website belong solely to the author of each article. These views and opinions do not represent those of Diabetes UK as a charity or any of its staff members.

 

 

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