The Alchemy of Transforming an Illness from Terminal to Treatable
Mr. and Mrs. Thompson were experiencing what was no doubt, the worst thing they could have imagined; their son was dying a slow, painful death. He’d been diagnosed with an illness that was fatal at the time. Their fourteen-year-old was experiencing startling weight loss, excessive thirst and urination, and severe fatigue. It would only become worse and worse, and they would have been all too aware that their child would not live long, given his condition.
The condition? Type One Diabetes; a disease that is now (thankfully) treatable, was a death sentence at the turn of the century when Leonard Thompson was diagnosed. As it would turn out, he would be the first recipient of a truly groundbreaking treatment. Through his treatment, those diagnosed with the disease could begin to hope for longer, more full lives.
The treatment? Insulin.
The road to finding treatment for this insidious disease began centuries before, mostly through diets. Patients’ food was restricted to the point of near starvation, and though it may have prolonged the result a little, the patient would ultimately succumb.
What is diabetes? Diabetes is a set of diseases that relate to chronic metabolic disorders regarding insulin and glucose regulation. To understand these, we must understand that the pancreas is a lovely little organ responsible for producing insulin, and regulating the balance of insulin and glucose from food in the body. This careful balance is, in essence, a delivery system through which insulin carries glucose to all the different systems in the body. This is an extremely simplified overview of the pancreas’ functions as it relates to the body, it is not an in-depth analysis (Breakthrough T1D.org, 2024).
Now that the pancreas is more or less understood, it is important to understand that for those diagnosed with type one diabetes (sometimes referred to as “juvenile” diabetes), the body attacks itself. Due to this autoimmune reaction, which is often triggered by a childhood illness, specifically targets the cells in the pancreas that produce insulin. Untreated, this causes insulin function to cease entirely in the sufferer, and, the results are ultimately a very miserable death.
This is because without insulin, the body still has glucose. Glucose in our bodies comes from food, and, from glucose stored in and distributed by the liver. Without insulin to pick up and deliver said glucose, the glucose begins to essentially clog the circular system. When this happens, there is food for the body, but no way to get it to where it needs to go, and so though the person may be eating, they are literally starving. To make matters more uncomfortable, the patient will become very thirsty as the body does everything it can to attempt to flush what it perceives as excess glucose from the body. Excessive thirst and urination are common first symptoms, even today, in newly diagnosed diabetics, due to high blood glucose levels.
Without insulin, the glucose in the body increases while almost paradoxically, the body starves. Eventually, the body can no longer function, and the patient dies.
The road to treatment started with two German researchers named Oskar Minkowski, and Joseph von Mering. They realized that when the pancreas gland was removed from dogs, the animals developed symptoms of diabetes and died afterword (American Diabetes Association, 2019).
Although they didn’t yet know what insulin was, this did allow them to conclude that there were substances in the pancreas that were essential for life, and without it, death would occur from diabetes.
More experimentation by other researchers led to a greater narrowing of substances that the pancreas produces for the body. This led to Sir Edward Albert Sharpey-Shafer suggesting that only one chemical was missing from the pancreas in people with diabetes. Shafer called this chemical “insulin” (American Diabetes Association, 2019).
Insulin’s discovery was still only one piece of the complex puzzle that was treatment for those afflicted by diabetes. We now use insulin that is chemically produced in a lab, but more rudimentary methods would have required great quantities of insulin to be obtained, then distilled before they were then distributed to patients. Even then, how would it best be distributed? Insulin is an astonishingly delicate hormone, destroyed by digestive juices, meaning oral medication was not an option. Though the basic design of a hypodermic needle was invented by Charles Pravaz in France and first used in sheep in 1853, disposable versions of hypodermic needles would not be available until the mid 19-50s (Craig, 2018).
Regardless, doctors and researchers soldiered on, and this is where our story brings us to Dr. Frederick Banting and Charles Best. The two figured out that insulin could be removed from the pancreas (they used a dog’s pancreas for their work), and then injected into a living dog with diabetes. Through this process, Banting and Best were able to keep the canine alive for seventy days. They confirmed that it was the insulin keeping the dog alive by (unfortunately) letting the dog succumb to its illness by withholding the insulin.
Banting and Best were joined by two of their colleagues, J. B. Collip and John Macleod. Their efforts brought us a more refined version of insulin through using a cow panceas. (citation)
This is where we again meet our friend, Leonard Thompson, in 1922. He was dying from diabetes in a hospital in Toronto. There, Leonard became the first person to ever receive an injection of insulin. The results were dramatic; hours after administering the insulin, Leonard’s blood-glucose levels dropped (UMass Diabetes Center of Excellence, 2019).
Leonard Thompson went on to live another thirteen years. Though still dying all too young, the fact that he was able to live with insulin injections through the nineteen twenties and into the nineteen thirties is what has led to longer and longer lifespans in those who were (and still are) diagnosed.
Leonard Thompson would have most likely used cow or pig insulin for treatment, but eventually, research led to the ability to create insulin chemically in labs. Not only that, but there are multiple kinds of insulin which allows for better treatment for blood glucose levels.
Speaking of blood glucose levels, the monitoring of these levels has become advanced alongside the refinement of insulin and it distribution. Those with diabetes used to need to manually sharpen their glass hypodermic needles prior to use, and now, multiple pumps (including options that are completely tubeless) are available. The monitoring of insulin dosages and glucose levels has gone from complex chemistry sets using urine samples to wearable devices that tell the wearer in real time what their blood glucose levels are. Even better, more and more insulin pumps and continuous glucose monitors are beginning to communicate with each other for even greater control over one’s glucose levels.
The discovery of insulin is a lesson in alchemy; scientific research turned a terminal illness into a treatable one. Eventually, it may even be a curable one. It’s a point in history that must be understood, remembered, and replicated so that the diseases we now categorize as “terminal” can be treated and one day, be cured.
Works Cited:
American Diabetes Association. (2019, July 1). The history of a wonderful thing we call insulin. American Diabetes Association. https://diabetes.org/blog/history-wonderful-thing-we-call-insulin
Breakthrough T1D.org. (2024, March 29). Type 1 diabetes - Diagnosis, symptoms, causes and treatment. Breakthrough T1D. https://www.breakthrought1d.org/t1d-basics/
Craig, R. (2018, December 20). Blog - Faculty of Medicine. University of Queensland. https://medicine.uq.edu.au/blog/2018/12/history-syringes-and-needles).
UMass Diabetes Center of Excellence. (2019, January 22). Leonard Thompson received first human insulin injection to treat diabetes. UMass Chan Medical School. https://www.umassmed.edu/dcoe/diabetes-education/patient-resources/first-insulin-injection/
Natosha Locken is a writer and anthropology student from the PNW. She writes about history, science, and anything else that seems interesting.