Insulin: from experiment to treatment

In Toronto in 1921, Banting and Best studied pancreatic extracts with facilities and physiological guidance from Macleod. Animal experiments examined changes in blood sugar and other measures as materials and preparation methods varied. Earlier laboratories had already investigated the relationship between pancreas and diabetes. The Toronto work continued toward a preparation usable in treatment. Repeated measurement and comparison exposed problems of stability and impurities as investigators tried to preserve an active substance.

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Collip improved extraction and purification, reducing unwanted components. In 1922 clinicians at Toronto General Hospital treated Leonard Thompson and other patients while recording blood, urine and clinical findings. The first preparation gave disappointing results; improved material produced clearer changes. Banting, Best, Collip and clinical colleagues reported the work. Reliable supply and careful administration were needed to turn laboratory and ward observations into treatment that could be continued beyond an initial case.

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University laboratories, Connaught and industrial partners expanded production and worked on purity and consistent potency. Treatment introduced continuing routines of administration, diet, testing and clinical follow-up. Insulin enabled many severely ill patients to survive for longer, while access to supplies and care shaped results. Later preparations and monitoring tools changed these routines. The work linked animal experiments and industrial manufacture with the repeated tasks of managing diabetes in everyday life.

References: [1]