History

Insulin (as pancreatic islet cell extract) was first administered to a 14-year-old insulin-deficient patient on 11 January 1922 in Toronto, Canada. An adult sufferer from diabetes who developed the disease in 1920 and who, because of insulin, lived until 1968, has told how:

Many doctors, after they have developed a disease, take up the speciality in it... But that was not so with me. I was studying for surgery when diabetes took me up. The great book of Joslin said that by starving you might live four years with luck. [He went to Italy and, whilst his health was declining there, he received a letter from a biochemist friend which said] there was something called 'insulin' appearing with a good name in Canada, what about going there and getting it. I said 'No thank you; I've tried too many quackeries for diabetes; I'll wait and see'. Then I got peripheral neuritis ... So when [the friend] cabled me and said, 'I've got insulin — it works — come back quick', I responded, arrived at King's College Hospital, London, and went to the laboratory as soon as it opened ... It was all experimental for [neither of us] knew a thing about it... So we decided to have 20 units a nice round figure. I had a nice breakfast. I had bacon and eggs and toast made on the Bunsen. I hadn't eaten bread for months and months ... by 3 o'clock in the afternoon my urine was quite sugar free. That hadn't happened for many months. So we gave a cheer for Banting and Best.1

But at 4 pm I had a terrible shaky feeling and a terrible sweat and hunger pain. That was my first experience of hypoglycaemia. We remembered that

1 F G Banting and C H Best of Toronto, Canada (see also Journal of Laboratory and Clinical Medicine 1922 7: 251).

Banting and Best had described an overdose of insulin in dogs. So I had some sugar and a biscuit and soon got quite well, thank you.2

Type I (formerly, insulin dependent diabetes mellitus, IDDM) which typically occurs in younger" people who cannot secrete tnsulin

Type 2 (formerly, non-insulin dependent diabetes melkus, NIDDM), which typically occurs in older, often obese people who retain capacity to secrete insulin but who are resistant to its action. These terms and abbreviations are used in this chapter".

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