March Historical Tidbit – Then and Now: This Month in Endocrine History
Submitted by Evan Graber, DO
In March 1922, Banting and Best published a preliminary report on the effect of subcutaneously administered pancreatic extract on a 14-year-old boy with diabetes. Previous attempts to treat diabetes with orally administered extracts had failed and the use of pancreatic extracts was almost abandoned. Banting and Best thought that the “internal secretion” that acts on carbohydrates was being destroyed by pancreatic digestive enzymes. After developing a method to isolate the pancreatic factor in question and after demonstrating that the extract prolonged the life of pancreatectomized dogs, they were ready to try the compound on humans.
The patient reported was diagnosed with diabetes in 1919 and treated with dietary regulation, the only available treatment of the time. He was only 65 pounds, his “urine at the time of admission was strongly acid,” and the test for sugar “strongly positive.” Daily injections of the extract decreased his blood sugar, urine sugar, and ketones and discontinuation of the injections reversed these improvements. While receiving injections, the patient reported “increased vigor” and felt physically better.
In just over 100 years, treatment of diabetes has evolved to include over a dozen different types of insulins, insulin pumps, continuous glucose monitors, and monoclonal antibody therapy to delay the onset of clinical diabetes.