The Noble and Often Nobel Role Played by Insulin-Focused Research in Modern Medicine

Abstract

Since diabetes was first described over 3,000 years ago, clinicians and scientists alike have sought ever improving treatments en route to a cure. As we approach the 100th anniversary of insulin's first therapeutic use, this article will recount the glorious history associated with research surrounding insulin's isolation, purification, cloning, and subsequent modification. The discovery path we will relate tells the story of many relentless and passionate investigators pursuing ground-breaking research. The fruits of their labor include several Nobel Prizes, new technology, and, more importantly, ever improving treatments for one of humankind's greatest medical scourges.

Figure 1

Such was the infighting that developed among the four principal participants contributing to insulin’s first purification and use that no known photographs of the group exist. The closest to a group picture was taken in Victoria, Canada, on 25 June 1936. Shown are J.B. Collip, C.H. Best, F.N.G. Starr (widow of a Founding Fellow of the American College of Surgeons), and F.G. Banting. Numerous stories detailed in The Discovery of Insulin describe the many bitter disputes, prompting Lewellys Barker, a Canadian professor of medicine at Johns Hopkins University, to state at the 1923 dinner to celebrate the announcement of the Toronto group’s Nobel recognition that “in insulin, there is glory enough for all” (8). That sage counsel was not adopted by the protagonists. Photo credit: https://insulin.library.utoronto.ca/islandora/object/insulin%3AP10049.

Figure 2

The Genentech/City of Hope team that created artificial human insulin genes (A and B chains), inserted those constructs into bacteria, and then successfully created human insulin manufactured in a bacterial system. Shown left to right are K. Itakura, A. Riggs, D. Goeddel, and R. Crea (who worked with several others not shown). The work launched the biopharmaceutical industry and has provided countless benefits not only to those with diabetes but also to many others worldwide treated with other bioengineered proteins. And unlike the Toronto group, the Genentech/City of Hope team avoided the internal rancor. Photo reproduced with permission from the City of Hope.

Figure 3

Where it all began, and where it will end at some future date. One of this article’s authors (D.M.H.) at Banting’s London, Ontario, home where he awoke with his inspired dream, and where that dream can reach its goal when the Flame of Hope is extinguished.