History of Diabetes - Part 2 | The Discovery of Insulin | इन्सुलिन की खोज

In the First Part History of Diabetes (Part-1) we discussed how Diabetes originated, what were the possible treatment options and management of Diabetes thousands of years back along with the present scenario.

Today we talk about the next part of history so fasten your seat belts, and let's get back in the history.

HISTORY OF DIABETES (PART-2)

According to WHO (World Health Organization) around the world, about 422 million people have diabetes, the majority of them living in developing and underdeveloped countries. Each year about 1.5 million deaths are directly attributed to diabetes. This number is predicted to rise to 643 million by 2030 and 783 million by 2045. The increase in the number of diabetic patients around the globe at an alarming rate is due to the consumption of high carbohydrate-rich diets and mismanaged lifestyles. 

Present Condition of Diabetes in India:

According to reports, there are 101 million diabetic and 136 million pre-diabetic patients in India. You will be shocked to hear that India ranks number 2 in terms of diabetic patients.

India is the most populated country, if we fail to manage diabetes then the day is not so far when every house in India will have diabetic patients. With proper knowledge and discipline diabetes can be managed well.

Diabetes and its references can be found in ancient texts. Here in this blog, we will dig deep into the past and discuss the breakthroughs that revolutionized the diagnosis, treatment, and management of diabetes.

Ancient: method of diabetes detection

Centuries ago, there were no scientific cures for diabetes. Doctors thereby tried to diagnose their patients according to observed symptoms, which included increased hunger, high urination rate, slow wound healing, increased thirst, and sudden weight drop confirming a patient to be diabetic. Till today symptomatic diagnosis and treatment are in use when the cause or permanent cure of the disease is not known, A recent example of COVID-19 where initially doctors tried to treat the symptoms to cure the disease.

Another method of diabetes detection that was popular at that time was a urine sample taste. The presence of a sweet taste in the sample confirms the patient is diabetic. It was very difficult for doctors to establish the stage and severity of diabetic patients at that time. 

Later around 1900, a scientist discovered a tablet that was used along with the urine sample. The urine sample is boiled along with the tablet for some time. The change in color of the sample confirms the patient with diabetes, the darker the color of the sample more severe the diabetes is.

As this test was being practiced there were some cases where the patients had the symptoms of diabetes but their urine sample test came out to be negative which means no sugar in urine. The presence of sugar in urine was already discovered in the year 1776 by Dobson. This test created a huge confusion over the diagnosis and treatment of diabetes.

Modern: methods of diabetes detection

Ivar Christian Bang made an important contribution to the field of diabetes research. Ivar Christian Bang, the father of modern clinical microanalysis first determined the glucose from dried blood spots in 1913. This discovery changed the thought process. Initially, it was thought that the presence of sugar in the urine confirmed the patient's diabetes, but with the discovery of sugar in the blood, the theory was revised, and it was established that the presence of sugar in the urine arises as a result of the increase of sugar in the blood. now the primary focus of diabetes testing has shifted toward blood sugar testing.

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Advanced method of diabetes detection

Technological advancements after 1900 in science and research led to many discoveries, one of them being the discovery of the glucometer in the 1970s. Where a single drop of blood is sufficient to know the blood sugar level within a few seconds. The device is portable and easy to use. It’s still widely used in Hospitals, homes, and healthcare centers. 

Continuous glucose monitoring devices like smartwatches and portable chips are easily available on the market, which continuously monitor the blood sugar level with high-end sensors without a drop of blood. This device can easily connect with mobile phones for better compatibility. 

The revolutionary discovery of insulin

The discovery of insulin was a breakthrough in the treatment of diabetes. In the early years, scientists around the world were trying to make insulin, which can be used by humans without any side effects. In this research, John Macleod was way ahead of others. He was the Head of the Department of Biochemistry at the University of Toronto, Canada. As he was way ahead of others in the research, he was very popular at that time. Due to his popularity, a doctor named Frederick Banting came across his name. Banting came from London and showed his interest in working with him. Banting managed to convince Macleod and both started to work on Insulin.

Charles Best who was a junior assistant of Macleod and also an expert in Biochemistry joined the team and started to work together. Years of research in the lab resulted in the discovery of their first sample. They injected the prepared sample into diabetic patients. In the initial stages, the blood sugar level was going down in the patients and the prepared sample seemed to be working effectively but after some time the patients to whom prepared insulin was administered developed an allergic condition. many patients showed the same pattern of response. The result obtained from the test forced them to analyze the prepared sample and the cause of the allergic reaction.

After years of research, they were not expecting such a result, and this started to demotivate the team. As a team leader, Macleod motivated the team and added another member to the team. James B. Collip was the new member who has expertise in Protein purification. 

All the experts coming under the same roof and working for the same purpose led them in the preparation of another purified sample. This time they were very confident that their prepared sample would be free from allergy reactions but on the other hand, they were worried too. For the test of the newly prepared sample, they chose a 14-year-old boy who was admitted to the hospital and was in his last stages. The condition of the boy was so bad that he could only survive a week. His increased blood sugar level was the main reason behind this. 

So, Macleod and his team decided to test the prepared sample and thus injected the sample. They discovered that the sample lowered the blood sugar level without any side effects. With the repeated injection of the prepared insulin sample, the boy recovered from ill health and his blood sugar level got normalized. This positive result boosted their confidence and they were so happy. 

Although Banting, Best, and Macleod discovered insulin in 1921 it was James Collip who later purified the sample, and this was the turning point in the history of insulin. In the year 1923, they won the Nobel Prize in Physiology or Medicine for their extensive work. Hence it was proved that only insulin can counter the increase in blood sugar level. When the body cannot produce enough insulin, the blood glucose level in the blood is increased, and an insulin injection is given to treat the patient. These points were totally clear to the whole world after the result obtained from the test. 

By the year 1950, a scientist discovered some pills that act on the pancreas to release insulin when there is an increased level of blood sugar. The discovery of penicillin in the year 1928 and the discovery of vitamins and minerals around the 1930s led allopathic medicine to great heights due to its fast relief and long-lasting activity. Those were the golden days in the history of the Allopathic practice of medicine. 

The discovery of Insulin and its external administration to patients saved millions of lives around the world. History witnessed, that when great minds come together something new is going to happen, the discovery of insulin. 

Rosalyn Yalow a nuclear physicist jointly developed radioimmunoassay (RIA) with doctor Solomon Berson. Small amounts of chemicals in the body, such as hormones in the blood, can be measured using RIA. Yalow and Berson developed a method to measure insulin levels in a patient's blood by injecting radioactive iodine. They were awarded the Nobel Prize in Physiology or Medicine in 1977 for this discovery.

Solomon Berson and Rosalyn Yalow

Later after years of research, it was discovered that the majority of diabetic patients have normal or more amount of insulin in their blood. which accounts for about 90% of total diabetic cases.

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In our next blog, we will continue with Real cause of Diabetes | Does Insulin Resistance Causes Diabetes.

See you in the next blog.