Monday Medical: The 100th anniversary of insulin | SteamboatToday.com
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Monday Medical: The 100th anniversary of insulin

Susan Cunningham
For Steamboat Pilot & Today

This article is the first part of a two-part series. The next installment looks at how insulin has changed over the years.

A life-saving medication is celebrating its 100-year anniversary this month: insulin.

Before insulin was discovered, Type 1 diabetes was fatal; now, it is a chronic condition that can be managed.



Dr. Jessica Devin, an endocrinologist at UCHealth Endocrinology Clinic in Steamboat Springs, outlines things to know about this important medication below.

Insulin’s importance

If you want to drive your car somewhere, you fill it with gas. Similarly, if you want your body to work, you eat food.



That food gets broken down through digestion until, eventually, your blood carries glucose to your cells to use as energy. But there’s a catch: For glucose to enter a cell, the hormone insulin — which acts as a key to open the door into each cell — must be present.

Insulin is naturally made in the pancreas. But with Type 1 diabetes, the immune system attacks the cells that make insulin. Without insulin, glucose builds up in a person’s blood, even as their cells are starving.

“Type 1 diabetes used to be a death sentence — it was death by starvation,” Devin said. “If you don’t have insulin, you’re unable to use the sugar and nutrients you eat, so you starve. Insulin helps you utilize your diet.”

With Type 2 diabetes, a person still produces insulin, but they may not make enough insulin, or the insulin may not be as effective, sometimes making it necessary to take insulin.

The history of insulin

Physicians have known about diabetes for centuries. In fact, Egyptian manuscripts from 1500 B.C. describe the condition. But for years, there was no treatment for the disease, and people with Type 1 diabetes didn’t live much more than a year after the onset of symptoms.

Then, in 1921, a young surgeon named Charles Banting, along with his assistant Charles Best, discovered a way to extract insulin from a dog’s pancreas and learned that the insulin could be used to keep a different dog with diabetes alive.

With the help of other researchers, including John Macleod, a more refined form of insulin was developed and, ultimately, tested on a 14-year-old boy who was dying from diabetes. Within hours of receiving insulin, the amount of blood sugar in the boy’s blood dropped to a normal level.

For many years, insulin from cattle and pigs was used to treat people with diabetes. Eventually, scientists discovered how to genetically modify bacteria and yeast to produce human insulin.

How is insulin used today?

People with diabetes take insulin through shots or a pump. Like other hormones, insulin would be broken down by the stomach if it was ingested.

Since insulin is injected, it must move through a layer of fat before entering the bloodstream. Scientists have found ways to modify insulin so that it reacts differently in this fat layer: Some insulins work fast to help decrease blood sugar after eating, while others work over longer periods of time to help keep blood sugar at a stable level.

Managing blood sugar with insulin

For people who don’t have diabetes, the body naturally calibrates blood sugar second by second to keep it within a healthy range.

But for people with diabetes, it’s a constant dance — and a lot of work — to try to keep blood sugars within a certain range. Various factors, from what you eat to how active you are, and from your stress levels to your hormones, can drive blood sugar high or low. If blood sugar stays high for longer periods of time, serious health complications may result, and if it drops too low, a person may go into a coma or even die.

Patients can work with their health care providers to determine how much insulin to dose with meals and throughout the day to manage their blood sugar.

“Where you are with managing blood sugar depends somewhat on where you are in life — if you’re 20 years old, you may have stricter blood sugar goals than if you’re an older adult,” Devin said.


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