Robert A Hegele , Grant M Maltman. Insulin’s centenary: the birth of an idea. Lancet Diabetes Endocrinol. 2020 Dec;8(12):971-977
Introduction
The discovery of insulin in Canada ranks among the leading triumphs of medical research; but is there an appropriate date to observe the centenary of this landmark achievement? There are several candidate milestones in the timeline that culminated in the isolation of insulin suitable for human use (figure 1). For instance, on May 17, 1921, Frederick G Banting and Charles H Best (under the supervision of John J R Macleod) commenced preclinical studies at the University of Toronto, Toronto, ON, Canada. On Aug 3, 1921, Banting and Best’s crude extracts from the pancreas of a dog first showed activity in reducing hyperglycaemia in a pancreatectomised dog. Activity was first shown in humans on Jan 23, 1922, when Leonard Thompson, a 14-year-old patient with type 1 diabetes at Toronto General Hospital, Toronto, ON, Canada, responded spectacularly to injections of a purified insulin extract that was prepared by James B Collip. Any of these dates would merit consideration to commemorate insulin’s centenary. However, we propose that the foundational event occurred months earlier in London, ON, Canada. The events that followed are well documented in numerous sources, including the definitive classic book, The Discovery of Insulin, written by the late historian Michael Bliss in 1982,1 along with Bliss’s biography of Banting2 and others.3–14 Here, we recount the events before and after the morning of Oct 31, 1920, which transformed the field of endocrinology.