Southwest Florida's Health and Wellness Magazine Health and Wellness Articles
By Andrea Hayes, MD, F.A.C.E.
In 2023, we commemorate the 100 year anniversary of one of the most remarkable discoveries in medical history – the isolation and purification of insulin, a hormone that revolutionized the management of diabetes. Since its discovery, insulin therapy has witnessed remarkable advancements which have dramatically changed the lives of people with diabetes.
The Discovery of Insulin: A Life-Saving Breakthrough
The story of insulin begins in 1923 when Sir Frederick Banting and Charles Best isolated insulin from the pancreas of dogs and pigs. This marked the birth of insulin therapy and an era of hope for individuals with diabetes who were previously condemned to a life of severe metabolic imbalances and early death.
The first significant milestone in insulin therapy was the successful treatment of a young patient with type 1 diabetes. This marked the beginning of an incredible journey towards making insulin accessible to millions of people worldwide.
Human Insulin: A Breakthrough in Compatibility
One of the most significant developments in insulin therapy came in the 1980s with the advent of human insulin. Before this breakthrough, insulin was derived from animal sources, predominantly bovine and porcine, which posed a risk of allergic reactions and insulin resistance in some patients.
Recombinant DNA technology allowed scientists to synthesize insulin that is structurally identical to human insulin, making it more compatible with the human body. Human insulin, available in both regular and NPH forms, represented a monumental leap in insulin therapy, offering better efficacy, fewer side effects, and increased safety for patients.
Insulin Analogues: Tailoring Insulin Therapy to Individual Needs
The late 20th century and the early 21st century witnessed further progress in insulin therapy with the development of insulin analogues. These are synthetic insulins designed to mimic the body’s natural insulin production more closely, providing greater precision and flexibility in diabetes management.
Rapid-acting analogues, such as insulin lispro and insulin aspart, have a faster onset of action, enabling patients to time their injections more closely to their meals. This helps reduce postprandial hyperglycemia and enhances overall blood glucose control.
Long-acting analogues, such as insulin glargine and insulin detemir, provide a stable basal insulin level over an extended period, minimizing the risk of hypoglycemia and allowing for once-daily dosing in some cases. This improved profile more closely resembles the body’s natural insulin secretion, offering better blood glucose stability.
Designer Insulins: A New Frontier in Customized Therapy
As we enter the third decade of the 21st century, the field of insulin therapy continues to evolve with the emergence of “designer” insulins. These insulins are engineered to offer precise control over various aspects of glycemic management.
Ultra-rapid-acting insulins like insulin glulisine and faster-acting insulin lispro, known as “designer” insulins, are formulated to provide even quicker glycemic control, ideal for specific patient needs, particularly those who rely on insulin pumps or who require fine-tuned insulin dosing.
Additionally, smart insulins are on the horizon, with the promise of delivering insulin in response to real-time glucose levels. These innovative insulins may revolutionize diabetes management, reducing the burden of constant glucose monitoring and insulin dose adjustments.
The 100-Year Milestone: A Reflection on Insulin’s Impact
The centenary of insulin’s discovery serves as a poignant reminder of the profound impact this hormone has had on the lives of people with diabetes. Prior to its availability, diabetes was a death sentence for those with type 1 diabetes and a life of severe metabolic struggles for those with type 2 diabetes. Insulin therapy has transformed these narratives.
Today, individuals with diabetes can lead longer and healthier lives, manage their condition more effectively, and experience fewer complications thanks to the advancements in insulin therapy. The introduction of human insulin, insulin analogues, and the potential for designer insulins has opened doors to more tailored and personalized diabetes management.
Challenges and Future Directions
While the progress in insulin therapy is remarkable, there are still challenges to be addressed. Access to insulin remains a concern in some parts of the world, and the cost of newer insulins can be a barrier to many individuals. Efforts to make insulin more affordable and accessible are crucial.
Furthermore, the field of insulin therapy continues to evolve. New technologies, such as closed-loop insulin delivery systems and artificial pancreas devices, are emerging, further automating insulin management and improving the quality of life for individuals with diabetes.
Insulin therapy has come a long way since its discovery 100 years ago. The journey from animal-derived insulin to human insulin, insulin analogues, and the concept of designer insulins has made diabetes management more precise and manageable. As we celebrate this remarkable discovery, it is important to strive for continued advancements, making insulin more accessible and effective for all who need it. The future holds promise for even more innovative approaches to diabetes management, further improving the quality of life for those living with this condition.
Andrea Hayes, MD received her Type 1 diagnosis at age 15. She is a board-certified endocrinologist who has been in practice for 25 years. She offers prompt appointments for patients in home, local office or via telehealth.
Naples Diabetes Concierge
For more information, call 239-641-8199 or visit: naplesdiabetesconcierge.com
