Diabetes Metab J.  2021 Sep;45(5):629-640. 10.4093/dmj.2021.0163.

A Century of Progress in Diabetes Care with Insulin: A History of Innovations and Foundation for the Future

• Lee SH
• Yoon KH

• KMID: 2520847
• DOI: http://doi.org/10.4093/dmj.2021.0163

Abstract

The year 2021 marks the 100th anniversary of the discovery of insulin, which has greatly changed the lives of people with diabetes and become a cornerstone of advances in medical science. A rapid bench-to-bedside application of the lifesaving pancreatic extract and its immediate commercialization was the result of a promising idea, positive drive, perseverance, and collaboration of Banting and colleagues. As one of the very few proteins isolated in a pure form at that time, insulin also played a key role in the development of important methodologies and in the beginning of various fields of modern science. Since its discovery, insulin has evolved continuously to optimize the care of people with diabetes. Since the 1980s, recombinant DNA technology has been employed to engineer insulin analogs by modifying their amino acid sequence, which has resulted in the production of insulins with various profiles that are currently used. However, unmet needs in insulin treatment still exist, and several forms of future insulins are under development. In this review, we discuss the past, present, and future of insulin, including a history of ceaseless innovations and collective intelligence. We believe that this story will be a solid foundation and an unerring guide for the future.

Keyword

Diabetes mellitus; History; Insulin

Figure

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  Fig. 1. Timeline of important discoveries, events (upper panel), and insulin products (lower panel) throughout history. 3D, three-dimensional; NPH, Neutral Protamine Hagedorn.

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  Fig. 2. The discovery of insulin by Banting and colleagues. (A) Letter of invitation from Macleod to Banting which was written on March 11, 1921. (B) A page from Banting and Best’s notebooks describing the positive effects of their pancreatic extract on canine test subjects. (C) A flowchart describing the results of a dog experiment. (D) The newspaper with the headline ‘Toronto doctors on track of diabetes cure’ on March 11, 1922. (E) A letter from one of the early patient Teddy Rider to Dr. Banting saying that he is well after insulin treatment. Photos taken by Seung-Hwan Lee at the exhibition ‘Insulin: Toronto’s Gift to the World’ at University of Toronto. Courtesy of the Thomas Fisher Rare Book Library, University of Toronto. More archival documents pertaining to the history and discovery of insulin can be accessed at https://insulin.library.utoronto.ca/.

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  Fig. 3. The future insulins under development.

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