December 30th, 2021: The 100th Anniversary of the Discovery of Insulin
First published Feb. 1, 2022
On December 30th, 1921, the team of Frederick Grant Banting, a surgeon of no distinction, but with an insightful idea, and Charles Herbert Best, a medical student and research associate, working with the support of John James Rickard McLeod, Professor of Physiology at the University of Toronto presented their findings that the pancreas held the key to the control of blood sugar in diabetic dogs. McLeod gave Banting his laboratory, his student research assistant, Best, several dogs with which to work, research supplies and then went on a summer vacation. He was openly skeptical that Banting’s idea had merit.
Within a few months Banting and Best isolated a fraction from the pancreas of dogs and demonstrated that it contained a factor that could normalize the blood sugar in dogs made diabetic by removal of their pancreas. Subsequently, a biochemist, James Bertram Collip, recruited by McLeod from the University of Alberta, assisted Banting and Best and isolated and purified insulin from the pancreas of cattle from slaughterhouses with the goal of using it to treat the human disease, insulin-deficient (type 1) diabetes mellitus. After Banting tested the product on himself to assure safety, on January 23, 1922, at the Toronto General Hospital, they administered purified bovine insulin to Leonard Thompson, a 14 year old boy with type 1 diabetes, the first person to be so treated. It lowered his blood sugar. Type 1 diabetes, which was a fatal disease, could now be managed. At the May 3, 1922 annual meeting of the Association of American Physicians, they convincingly showed the effect of purified bovine insulin in humans with type 1, diabetes. The team first presented their experimental findings in dogs at the December 30, 1921 meeting of the American Physiological Society in New Haven, Connecticut.
In 1923, Banting and McLeod were awarded the Nobel Prize in Physiology or Medicine. They satisfied Alfred Nobel’s precise goal stated in his Will that “…shall constitute a fund, the interest of which shall be annually distributed in the form of prizes to those who, during the preceding year, shall have conferred the greatest benefit on mankind“. The Nobel Foundation has, wisely, ignored the timing proposed by Nobel. Best and Collip were not included among the Prize recipients. This omission was the result of the nominators for the prize being unaware of their contributions. International communication among scientists in 1922 was rudimentary. McLeod financed the initial work, provided his research facilities, a research assistant and recruited Collip for the purification. He was an internationally recognized expert on carbohydrate (sugar) metabolism. Banting, who felt Charles Best deserved to be recognized by the Nobel Foundation, shared his monetary prize with Best. McLeod shared his with Collip. Fifty years later, the Nobel Foundation indicated that Best should have been included in the nomination with Banting and McLeod (no more than three nominees can share a Nobel Prize); but, they, and their carefully selected nominators around the world, were unaware of his role. This was a very unusual, perhaps unique, mea culpa from the Nobel Foundation. Best, eventually, succeeded McLeod as Professor of Physiology at the University of Toronto and had a distinguished academic career with many honors bestowed as the co-discoverer of insulin.
The work on isolating and studying the effects of insulin resulted in a revolution in biomedicine and was a life-saving therapy for persons with type I diabetes mellitus. It propelled the notion that understanding the science of a disease could lead to its treatment or cure. It led, eventually, to a deeper understanding of insulin’s complex role in human metabolism. It is one of the great milestones in medical research.
Charles Best and Frederick Banting. University of Toronto, 1924