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Insulin 90 years on – but rate of diabetes still soaring

Exactly 90 years ago today a 14-year-old Canadian boy, Leonard Thompson (pictured right), became the first person with diabetes to be successfully treated with insulin.

Without this medical breakthrough, a million people in the UK who are kept alive with daily insulin injections would not be here. Prior to insulin treatment a diagnosis of Type 1 diabetes was an invariable death sentence, with patients usually surviving for only a few months, and often just weeks or days.

Since the historic treatment – arguably one of the greatest medical advances of the twentieth century – millions of people worldwide have used insulin, usually in the form of injections, to regulate their blood glucose levels and stay alive.

Banting discovers insulin

In 1922 Dr. Frederick Banting (pictured below) discovered insulin and its positive effect on the body, originally using dogs in medical trials.

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Leonard Thompson, a 14-year-old boy who had been diagnosed with Type 1 diabetes two years previously, was the first person for whom insulin came to be a life-saving drug.

Although his first experience of insulin was not successful, once the hormone extract had been improved, Leonard received a suitable dose in an injection on 23 January 1922. Thanks to insulin injections he went from a 65 pound boy close to death through malnourishment – the only treatment at this time for diabetes was a starvation diet – to live into adulthood.

Following the successful delivery of purified insulin, for the first time in history there was clear, unambiguous evidence that scientists were able to replace the natural insulin that is not produced in people with Type 1 diabetes. The condition develops if the body is unable to produce any insulin and is therefore life threatening without the treatment first used by Banting. Type 1 diabetes accounts for around 10 per cent of all cases.

A step towards self-management

In 1934 novelist HG Wells and his practitioner Dr RD Lawrence, both of whom had diabetes, set up the Diabetic Association aiming to make sure that everyone in the UK could gain access to insulin. The charity called for a national health service and stressed the importance of self-management of diabetes, given that the condition was life-long. This charity later became Diabetes UK.

Today, Diabetes UK is the leading charity for over 3.7 million people in the UK with diabetes – 2.9 million diagnosed and an estimated 850,000 who have diabetes but do not know it – their families and friends, and healthcare professionals.

Developments through the ages

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Sheila Thorn(pictured right), 80, has seen developments in insulin through the ages, having originally been treated with insulin by Banting himself in Toronto, Canada. "When I was diagnosed with diabetes as a baby, insulin still wasn’t widely available. I was lucky enough to be treated by the pioneers of insulin and that’s why I’m still here today. Since then, I’ve seen a lot of changes in the way people use insulin and these days I use an insulin pump to control my own condition.

"I’m thrilled to see that people with diabetes can live long and happy lives for generations to come thanks to this treatment," she said. After moving back to the UK as a child, Sheila was later treated by Dr RD Lawrence, co-founder of Diabetes UK.

The journey of insulin

Since the 1980s, insulin has been synthetically manufactured using bacteria and newer developments have included analogues of the insulin molecule which can be manufactured to work more rapidly or more slowly than natural insulin. New devices have increased the safety and comfort of self-administering insulin.

Far from the days of glass syringes and reusable needles, people with Type 1 diabetes now have a choice of injection pens. Insulin pumps (continuous subcutaneous insulin infusion) regulate the blood sugar levels in a way which suits someone’s condition and lifestyle, although currently not everyone who wants an insulin pump is able to obtain one from their local NHS trust.

"I control my diabetes, rather than diabetes controlling me"

Amy Turner, 28, was diagnosed with Type 1 diabetes seven years ago and although she took some time to adjust to injecting insulin, she knows it keeps her alive. She said, "Learning to use insulin effectively means I can control my diabetes, rather than diabetes controlling me. It means I can still have a great quality of life and do most of the things I want to; I’ve even been skydiving and white water rafting.

"I’m very active and think an insulin pump would really suit my lifestyle – I’d have a lot more control and flexibility than the structure of the insulin injections I take at the moment. Unfortunately, there seems to be a bit of a postcode lottery when it comes to the insulin pump and I’ve been told I’ll need to join the queue for now."

Diabetes UK spends a total of about £6 million every year on research projects related to all aspects of diabetes, including insulin. Our current research portfolio costs about £20 million and includes around 125 different grants.

"A long way to go"

Barbara Young, Diabetes UK Chief Executive, said, "Diabetes UK has developed enormously in the range of support we provide for people living with diabetes, including the funding of groundbreaking research in such areas as improving care, providing new treatments, education and genetics.

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We are proud and excited to be funding research into an artificial pancreas device which has the potential to transform lives. Studies are now being carried out into adapting these advances to home settings with the aim of providing them as a feasible option for treatment of adults with Type 1 diabetes.

"Our founders worked to ensure insulin was available and, thanks to Banting’s fantastic discovery, one million people in the UK are able to live healthy lives. However, there is still a long way to go.

15 healthcare essentials

"Millions are affected by diabetes but with health screening and early diagnosis, people can act to reduce their risk. Yet people with diabetes are still not getting the care they deserve. That’s why we’ve launched the 15 healthcare essentials – which outline the checks and specialist services all people with diabetes should receive – and we are calling for the NHS to provide this care to help people manage their diabetes and reduce the risk of devastating complications such as heart disease, stroke, kidney disease, blindness and amputation.

Make diabetes a top priority

"Over 130,000 people were diagnosed with diabetes in the UK in the last year, and five million people are expected to be living with the condition by 2030. This is a challenge that cannot be ignored so it is fundamental that the Government makes diabetes a top priority, tackling the rising rate of diabetes and improving care for those living with this serious condition.

"Diabetes UK will continue working to ensure that they receive all of the care they need and cease to face unnecessary challenges in everyday situations such as driving, at school or at work."

The future of diabetes

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Looking forward, research like that undertaken by Professor Ken Siddle (pictured right) of the University of Cambridge on exploring the mechanisms by which variation in the human genetic code influences the action of insulin, hopes to shed more light on insulin and how it can be used to treat diabetes. Overall, Professor Siddle is optimistic about the future. He thinks that within the next 10–20 years there will be both better definitions of the various causes of diabetes and a wider range of drugs available for targeting those causes.

To mark the 90th anniversary of the first successful use of insulin, Barbara Young, Chief Executive of Diabetes UK, has written a piece for the Guardian aboutwhat more can be done to tackle diabetes in the UK.

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