Self Expression Magazine

The Sweet and Bitter History of Insulin—The First Biologic

Posted on the 24 January 2025 by Jhouser123 @jhouser123

Volume 2 in the Fantastic Drugs and Where to Find Them series!
Make sure you check out Volume 1 where we dragged ourselves out of the stone age (small molecule drugs).

Few medical breakthroughs have reshaped human health as profoundly as insulin. Not only did it revolutionize diabetes care—turning a once-fatal disease into a manageable condition—but it also laid the groundwork for modern biomedicine and raised enduring questions around science, ethics, and equitable access. Yet the story of insulin is more than a mere discovery tale; it’s a saga of audacious ideas, tireless collaboration, and an ongoing struggle to ensure this lifesaving therapy reaches everyone who needs it.

A Deadly Mystery: Diabetes Before Insulin

Long before scientists isolated insulin, the condition we now call diabetes confounded healers across millennia. Ancient Egyptians described it as a mysterious “passing of too much urine,” while Indian physicians called it “madhumeha” (“honey urine”), noticing that ants were attracted to the sweet-smelling urine of patients. Despite these observations, the disease’s root cause remained hidden, and the prognosis was typically dire.

By the late 19th century, researchers had begun to probe diabetes more systematically. In 1889, Oskar Minkowski and Joseph von Mering showed that removing a dog’s pancreas triggered severe diabetes, hinting that this organ held a key to blood-sugar control. Still, the elusive substance—insulin—remained unknown, and the quest to identify it became a race against time for millions of suffering patients.

The Race to Discover Insulin

The breakthrough arrived in the early 1920s in Toronto, Canada, thanks to Frederick Banting—a determined surgeon with an unconventional idea. Working alongside medical student Charles Best, Banting devised a method to isolate secretions from pancreatic islets of Langerhans. Their preliminary experiments on dogs showed that this extract could dramatically lower blood sugar in diabetic animals.

With support from J.J.R. Macleod, who provided lab space and mentorship, and James Collip, who refined the extract for human use, the team made medical history. In January 1922, they treated Leonard Thompson—a 14-year-old on the brink of death from diabetic ketoacidosis. The outcome was nothing short of miraculous: his blood sugar dropped, and his health rebounded. Well… it actually took two shots to get it right. The very first injection on January 11 initially caused an allergic reaction due to impurities in the preparation. A more refined extract was administered on January 23, leading to the dramatic improvement. The true message of this success was that a robust manufacturing process would be needed to get this lifesaving drug to patients.


Insulin’s Commercialization and Ethical Quandaries

True to their altruistic vision, Banting, Best, Macleod, and Collip patented insulin but sold those rights to the University of Toronto for $1, hoping it would remain widely available. Yet the path from lab bench to pharmacy shelves was complicated. Eli Lilly and other pharmaceutical companies scaled up insulin production, using animal pancreases to meet demand.

Amid this rapid commercialization, tensions arose. Conflicts over credit plagued the original team: Banting famously bristled when the Nobel Prize was awarded jointly to himself and Macleod, believing Best’s contributions were underrecognized. Moreover, insulin’s journey into the commercial sphere sparked early debates on drug pricing—a conversation still relevant today as the affordability of insulin continues to weigh on patients worldwide.

From Animal Hormone to Engineered Marvel

For decades, the only insulin available came from cows and pigs, which sometimes caused allergic reactions. That changed in the 1970s when scientists harnessed recombinant DNA technology to produce human insulin in bacterial cells. Genentech, a pioneer in biotechnology, led the effort, culminating in the 1982 approval of “Humulin,” the first genetically engineered drug. This watershed moment ushered in today’s era of synthetic insulin and analogs, engineered to fine-tune absorption rates and reduce side effects.

Recent Advances: Novel Forms and Delivery Methods

Innovation in diabetes care continues to accelerate. Ultra-rapid-acting insulins now better mimic natural insulin response, and long-acting analogs like insulin degludec help stabilize blood sugar over extended periods, lowering the risk of dangerous nighttime hypoglycemia. Novel delivery systems—from smart pens that log dosages digitally to inhalable insulin—offer more convenient alternatives for patients wary of needles.

Research into glucose-responsive insulin (GRI) brings even greater promise. These formulations aim to release insulin only when blood sugar spikes, potentially eliminating the constant balancing act between hyperglycemia and hypoglycemia. Though still in trials, GRIs could dramatically simplify diabetes management and further reduce the risks of this lifelong condition.

The Challenges of Accessibility

Despite a century of progress, insulin remains at the center of fierce debates over healthcare equity. Many patients struggle to afford the drug—especially in the United States, where prices have soared. Efforts to address these disparities include pushing for regulatory reforms, promoting generic alternatives, and launching nonprofit collaborations like “Life for a Child.” The World Health Organization’s prequalification programs and other global initiatives also work to ensure insulin’s availability, particularly in low-income regions.

A Legacy of Hope and Innovation

Insulin’s discovery was more than a singular medical triumph. It was a testament to human ingenuity and compassion—embodied by Banting, Best, and their colleagues—who insisted that their breakthrough should benefit as many people as possible. From the dramatic experiments in a small Toronto lab to the complex biomanufacturing processes of today, insulin has transformed millions of lives and inspired a century of scientific advancement.

Yet the journey is far from complete. Controversies surrounding pricing and access persist, reminding us that even the greatest scientific achievements can be hampered by systemic barriers. Still, insulin’s story brims with optimism and enduring promise: it stands as both a lifesaving therapy for people with diabetes and an example of how science, when guided by empathy, can revolutionize healthcare.

As we look to the future, insulin remains a beacon—symbolizing the boundless possibilities of discovery, the ethical responsibilities of lifesaving therapies, and the unwavering hope that drives us to keep innovating.

Stay Curious!


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