This Day in Medical History

Jan. 11, 1922 – A Toronto resident, 14-year-old Leonard Thompson, becomes the first patient to receive injections of insulin, a new medication for treating the dreaded “sugar disease.” Diabetic for the last two and a half years, Thompson had already beaten the automatic death sentence given to most Type 1 diabetes patients of the time. But his situation had become dire, as he had fallen to 65 pounds and was about to slip into a coma.

Fortunately, Thompson was about to benefit from months of work on one of the great medical discoveries of the 20th century. It all began with an overly anxious medical instructor, Dr. Frederick Banting, who, thinking his lecture for his first-year students the next day wasn’t good enough, took his medical journal to bed. Waking in the middle of the night, he wrote down his inspiration – the idea that would lead to insulin.

After laboring through sweltering summer of 1921 in a University of Toronto laboratory, Banting and his assistant, Charles Best, successfully tested a pancreatic extract on a diabetic dog. Banting’s paper on his discovery, delivered six months later at Yale University, received a tepid reception. But after some initial skepticism, he had won the approval of Dr. John J.R. MacLeod of the university’s physiology department, who put at Banting’s disposal as many resources – notably lab space and a team of assistants – to continue his explorations.

Thompson’s first injections of pancreatic extract, prepared by Banting and Best, were followed two weeks later by a purified extract from chemist James Bertram Collip. By the end of February, with Thompson’s blood sugar returning to normal and his strength returning, the procedure is considered a success.

In May 1922, Eli Lilly and Co. and the University of Toronto signed a deal for the mass production of insulin in North America. In 1923, Banting and MacLeod were awarded the Nobel Prize in medicine/physiology (a much-needed boon to the soft-spoken, modest Banting, who had been so broke during his summer in the hot laboratory that his father and brother funded his work). The two Nobel Prize laureates shared their awards with their closest colleagues – Banting with Best, MacLeod with Collip. Twelve years after the successful injection of Thompson, Banting was knighted for his pioneering medical research.

Though he eventually died of diabetes complications, Thompson had managed to live 15 years after the first injection – an astounding advance for the time. Today, it is estimated that more than 15 million diabetics are alive today because of the drug.

As great a success story as this is, the full benefits of insulin have still not reached all corners of the world, even eighty-six years later. An estimated 19,000 Type 1 diabetes patients exist in 41 countries defined by the World Bank and the International Monetary Fund as “Highly Indebted Poor Countries.” That economic deprivation has resulted in life expectancies of as little as one year for children with newly diagnosed Type 1 diabetes in much of sub-Saharan Africa.