A century ago in Stockholm, Sweden, Dr. Frederick G. Banting delivered a lecture accepting the 1923 Nobel Prize in Physiology or Medicine for the discovery of insulin.  The award was shared with Prof. Dr. John J. R. Macleod, Department of Physiology, University of Toronto.  The discovery started with experiments on pancreatectomized dogs in the summer 1921, progressing during the next year to the stage where purified, insulin-containing, whole-beef pancreatic extracts were injected into several diabetic patients at the Toronto General Hospital.  The research team responsible for the discovery and purification of insulin consisted of Banting, Macleod, Charles H. Best (student), and Dr. James B. Collip (biochemist).  The discovery was acclaimed internationally as miraculous, and took place despite deep professional differences between the researchers.  The fact that only Banting and Macleod received the Nobel Prize helped to increase the friction within the group.

In his lecture (https://www.nobelprize.org/prizes/medicine/1923/banting/lecture/), Banting summarized elegantly the research leading to the discovery and subsequent use in human diabetics of purified insulin-containing pancreatic extracts.  Among the topics discussed were the previous efforts with pancreatic extracts by researchers other than the Toronto group; a technique known as duct ligation to obtain concentrated endocrine pancreatic extracts; injections of pancreatic extracts in pancreatectomized dogs leading to the lowering of sugar levels in blood and urine; experimental hypoglycemia in dogs; the case history of an experimentally pancreatectomized dog (Marjorie) kept alive for 10 weeks with extract injections; extract purification methods developed by Collip; and the first diabetic patients with reduced blood sugar levels and improved quality of life following treatment with purified extracts.

Banting’s Nobel Prize acceptance lecture marked the end of the insulin discovery period and the beginning of research efforts worldwide on the structure and biochemistry of the molecule, fine-tuning the methods to supply the hormone to insulin-dependent diabetics, and unravelling the mysteries of carbohydrate metabolism in humans.  In Banting’s future lay the widespread availability of recombinant human insulins; alternate treatment schemes besides injections such as open- and closed-loop mechanical systems; and implantation of intravascular and extravascular membrane-based devices containing insulin-secreting pancreatic tissue.  Although mostly experimental, these strategies are still being actively researched, and are aimed at providing continuous regulation of blood glucose to avoid the many complications of diabetes.

September 15, 1925, was a landmark date representing the acceptance of a huge scientific award by Banting as well as the dawn of an era of improved quality of life for millions of insulin-dependent diabetics.  On that day Banting could not have anticipated that the quest for alternatives to replace insulin injections continues to this day.  Substantia commemorates proudly the centennial of Banting’s acceptance lecture for the discovery of insulin.

 

 

Prof. Carlos A. Ramírez (retired)

Department of Chemical Engineering, University of Puerto Rico

Mayagüez, Puerto Rico, USA