Today, one in 11 people in the world have diabetes. This figure is projected to rise to one in nine by 2045 if left unchecked. Two out of three people with type 2 diabetes live in cities.
Globally 40 million children under five are overweight and are potential soft targets for type 2 diabetes and adult obesity.
But even while the number of people living with diabetes continues to grow at an alarming rate, the good news is that we are fortunate to have better medicines than ever. One such ground-breaking innovation that has saved countless lives is insulin. Hundred years ago a team of Canadian researchers from the University of Toronto extracted insulin from a dog’s pancreas to treat people with diabetes.
Before the discovery of insulin by Sir Frederick Banting, Charles Best and James Collip in 1921 diabetes was considered a fatal disease. It could only be controlled and prevented from going from bad to worse by fasting and calorie-restricted diets (often called a “starving diet”). There was no sure shot cure to maintain blood sugar levels and keep people with severe diabetes (type 1 diabetes) alive for more than a few months.
Frederick Banting and his team managed to obtain pancreatic extracts that could rescue patients from the edge of death due to starvation, the only treatment available at that time. This discovery transformed diabetes from a death sentence to a chronic condition.
On 11 January 1922 Leonard Thompson, a 14-year-old boy who weighed just over 29 kilos was injected with the first-ever insulin injection (described as a thick brown muck) – anywhere in the world. However, he developed an acute allergic reaction and had to be injected with a second dose of purified insulin on 23rd January. This worked. His blood and urinary sugars dropped down to normal and Leonard lived for another 13 years.
Banting and Macleod were awarded the Nobel Prize for Medicine in 1923. Banting then 32, remains the youngest awardee to win the coveted Prize.
This led to the mass production of insulin to treat and dramatically improve the life expectancy of people diagnosed with diabetes.
In 1923 Hans Christian Hagedorn and August Krogh obtained the rights for insulin and floated Nordisk Insulinlaboratorium which is known today as Novo Nordisk. In the 1930s while trying to modify the absorption rate of insulin, Hagedorn came up with a compound known as NPH (neutral protamine Hagedorn) insulin. The NPH insulin prolonged the effects of insulin and meant that people with diabetes now needed fewer insulin injections.
Since then Insulin has saved millions of lives and is considered to be one of the greatest medical achievements of all time.
With time it became clear to researchers that there are several types of diabetes with distinct characteristics and specific medicines for their treatment.
The 1970s saw the development of a portable glucose meter that simplified blood sugar monitoring and made it easier for people to keep track of their sugar levels by using test strips at home. Another big development was the evolution of the HbA1C test to assess the average blood glucose level during the past 120 days which enabled physicians to assess the long-term impact of medication and lifestyle changes.
The 1980s led to the easy access of the first commercially available human insulin identical to the insulin produced by our bodies and the first “mini” insulin pump which made it possible for people with diabetes to pump in insulin as and when required throughout the day. The next big development was the first insulin pen which immensely improved the quality of life of people suffering from diabetes by eliminating the need for cumbersome glass syringes and made way for a discrete and more accurate means of self-administering insulin when needed.
The late 90s saw the introduction of insulin analogues (a range of rapid-acting and premixed formulations) and continuous glucose monitoring (CGM) devices that help people to avoid low blood sugar levels and reduce the risk of weight gain.
The development of the GLP-1 class of drugs, which reduce blood sugar levels and boost natural insulin secretion while reducing hunger and food intake, is a game-changing finding that is sure to make life easier for patients with type 2 diabetes.
We see new medicines and innovative devices in the future that will provide greater flexibility and a more holistic approach to diabetes management. Next-generation oral treatments, breakthrough digital health solutions, transformative stem-cell therapies, and curative diabetic treatments are some of the possibilities over the horizon.