The success story of a life-saving hormone
In July 1921, Canadian researchers Frederick Banting and his assistant Charles Best achieved a revolutionary breakthrough: they succeeded in isolating insulin from dogs’ pancreas for the first time and were also able to demonstrate its blood glucose-lowering effect - thus laying the most important foundation stone for the effective treatment of diabetes mellitus. At last there was justified hope of saving the lives of children with diabetes, who until then had only survived an average of one to two years after diagnosis without any option of therapy.
Today, more than 400 million people worldwide suffer from diabetes. Only 100 years ago, the disease was fatal and there were hardly any other treatment options apart from a strictly low-carbohydrate diet. Since the discovery of insulin, many lives around the world can now be saved and successful diabetes therapy can be provided. Insulin was used for the first time in 1922 on a 13-year-old boy with diabetes – with resounding success: his dangerously high blood glucose levels improved instantly and he lived for a further 13 years with insulin substitution before dying of pneumonia.
Production and processing of insulin
Until the middle of the 20th century, insulin was still obtained from the pancreas of slaughtered farm animals (pigs and cattle). In addition to problems in obtaining, extracting and transporting insulin, the purification process in particular had not yet been perfected. Intolerance reactions at the injection site were observed quite frequently. In 1982, in the quest for optimisation possibilities, so-called human insulin was introduced for the first time, a genetically engineered insulin produced from reprogrammed yeast cells or bacteria, which was comparable to human insulin in its protein structure and therefore well tolerated.
In the beginning, only rapid-acting insulin was available. Over the years, however, insulins were developed whose duration of effectiveness could be influenced by additives.
In the meantime, long-acting and very rapid-acting analogue insulins have become available, which differ from natural insulin in terms of their duration of action and their action profile due to a change in the insulin molecule.
Optimisation of aids for diabetes therapy
Diabetes therapy still posed a real ordeal in the early 20th century: glass syringes were used, the thick needles had to be sharpened regularly and blood glucose could only be measured directly in a hospital. However, as time went on, there have been great advances in the development of insulin delivery devices. At the same time, people with diabetes were given the opportunity to treat themselves more independently: diabetes education and home blood glucose meters had made life easier for many of those affected. The first insulin pumps became available for general use in the 1980s. Disetronic, from which Ypsomed later emerged, was a leader in research and development and brought the first insulin pump onto the market. These days, patients can choose from a variety of therapy options in consultation with their physician –a highly developed technology and advancing digitisation make it possible to facilitate and improve diabetes therapy and thus achieve a high degree of flexibility in everyday life.
Quo vadis – and where we are going
More recent developments go even further, namely in the direction of an artificial pancreas, the so-called closed loop: here, an algorithm controls the automatic insulin delivery of the pump based on the glucose concentration values generated by continuous glucose monitoring (CGM).
As a result, we can certainly look forward to what current research and development has in store for us – because millions of people still need the best possible support – to live their lives with diabetes as comfortably as possible. With its mylife Loop development programme, Ypsomed is also moving in exactly this direction. The programme is being rolled out in three stages using app-based functional enhancements – with the prime objective of enabling automated insulin delivery (AID) via a smartphone, thus making life easier for many people with diabetes. Join us on the journey into the future of personalised diabetes management.