History of Insulin Administration For Treatment of Diabetes Mellitus Type 1

On 11 January 1922 insulin was first used successfully in the treatment of diabetes.

Insulin was discovered by Sir Frederick G Banting , Charles H Best and JJR Macleod at the University of Toronto in 1921 and it was subsequently purified by James B Collip.

Sir Frederick G. Banting

Before 1921, it was exceptional for people with Type 1 diabetes to live more than a year or two. One of the twentieth century’s greatest medical discoveries, it remains the only effective treatment for people with Type 1 diabetes today.

N.B. :Diabetes Mellitus (DM) type 1 is also termed insulin dependent DM (IDDM) or juvenile onset diabetes.It usually occurs before the age of 20 years.Most probably, it is an autoimmune disease causing destruction of pancreatic B cells.Abput 80% of new-onset patients have islet cell antibodies (ICA) or insulin antibodies.Also,virus infections as a causative factor are considered.The amounts of insulin secreted is markedly reduced and the only treatment is insulin injection.Patients are more liable to develop ketosis than type 2(Reference:Cairo University Textbook of Basic Medical Biochemistry Volume 11,Dr Emad Zaki Abbas,page 126)

First successful use

On 11 January 1922, Leonard Thompson, a 14-year-old boy with diabetes, who lay dying at the Toronto General Hospital, was given the first injection of insulin. However, the extract was so impure that Thompson suffered a severe allergic reaction, and further injections were cancelled.

Over the next 12 days, James Collip worked day and night to improve the ox-pancreas extract, and a second dose was injected on the 23 January. This was completely successful, not only in having no obvious side-effects, but in completely eliminating the glycosuria sign of diabetes.

Insulin is administered whether by intravenous injection(must be administered together with glucose or others depend on case as insulin may cause severe hypoglycemia),intramuscular & subcutaneous injection but not by oral administration as insulin will be digested by oral digestive enzyme

A dramatic moment

Children dying from diabetic ketoacidosis were kept in large wards, often with 50 or more patients in a ward, mostly comatose. Grieving family members were often in attendance, awaiting the (until then, inevitable) death.

In one of medicine’s more dramatic moments Banting, Best, and Collip went from bed to bed, injecting an entire ward with the new purified extract. Before they had reached the last dying child, the first few were awakening from their coma, to the joyous exclamations of their families.

Uncontrolled diabetic patient may suffer gangrene that lead to amputation

Source : Medical News Today

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