Remembering the old days of insulin

The discovery of insulin is one of the most enthralling detective stories filled with drama, intrigue and competition. Noy Pullen introduces us to two of the first insulin patients and how the discovery changed their lives.


First people treated with insulin

Imagine the medical world before insulin was discovered in 1921. This was what Leonard Thompson and Elizabeth Hughes had to face when they were diagnosed with diabetes mellitus some years prior to this.

Leonard Thompson. Photo courtesy of Eli Lilly and Company Archives. Copyright Eli Lilly and Company. All Rights Reserved.

Leonard Thompson

Leonard Thompson was the first patient treated with insulin by Dr Fred Banting, one of the four researchers credited with the discovery of insulin.

When Leonard was taken, by his father, to the Toronto General Hospital, Leonard weighed 65 pounds (22,6kg), and was drifting in and out of a diabetic coma.

As a result, Leonard’s father agreed to let the doctors inject Leonard with this new fluid, called insulin, made from bovine pancreas. Within days, a miracle had taken place as the 14-year-old regained his strength. He went on to enjoy another 13 years of life, dying from pneumonia. When told of the news, Banting’s comment was, “I hope he had a good life,”

Elizabeth Hughes

Elizabeth Hughes, daughter of a prominent politician, was one of the first Americans to receive insulin. She had been a sporty child with great dreams when, aged 11, she was diagnosed with diabetes.

Diagnosed in 1919, she struggled through three years of the only treatment used then: starvation therapy. She hoped she would live until insulin was past the experimental stage.

She found solace in reading, which did not tax her strength and ignited her dreams to travel to all the wonderful places she had read about.

Not her mother’s pleading nor her father’s position and influence could help at this stage. She took in less than 300 calories a day and exercised conscientiously.

Elizabeth Hughes

Starvation therapy

Before 1921, Dr Frederick Allen, ‘father’ of the starvation therapy method, ran a successful clinic in America for those living with diabetes Type 1.

A starvation diet was worked out for patients; keeping them alive yet free from blood sugar in the urine. It has been reported that Dr Allen ran his clinic like a military operation and patients were locked away for up to five months.

One British patient, Rene Mason, recalled, “Before I was put on to insulin I was starved. My mother would lock the larder. I would steal the dog biscuits.” Another patient on starvation therapy, John Johnson, recalled being forced to live on boiled cabbage water from Friday to Monday.

While on the diet, one of Dr Allen’s young patients kept having high sugar levels. After interrogation, the patient admitted that he secretly ate toothpaste and the bird seed meant for his canary, which he had cunningly asked for as a pet.

Another enterprising patient, on the third floor, made a deal with the newspaper boy to tie sweets onto the end of a long piece of string every day.

Breakthrough

Margaret Kienast, a nurse who worked with Dr Allen recalled, “The hope of insulin cajoled the patients into new life. Diabetics, who had not been out of bed for weeks, began to trail about, clinging to walls and furniture.”

When Dr Allen appeared in the doorway, after visiting Dr Fred Banting on the patients’ behalf, he caught the beseeching gaze of hundreds of pairs of eye. “I think I may have something for you,” he said softly.

Consequently, Elizabeth Hughes – who was in Dr Allen’s clinic – became Banting’s prize patient. In hand-written notes, he described what he saw: weight 45lbs (20kg); height 5ft (1,5m); extremely emaciated; slight oedema of the ankles; skin scaly and dry; hair brittle and thin; muscles extremely wasted; subcutaneous tissue almost completely absorbed; and scarcely able to walk due to weakness.

The change in Elizabeth was described as dramatic – almost magical. Furthermore, it has been reported that she said, “Oh, it’s simply too unspeakably wonderful for words, this stuff…To think I’ll be leading a normal healthy existence is beyond all comprehension!”

Samples of insulin from the early days of the drug’s development. Photo by SSPL/Getty Images.

A good life on insulin

As a result, Elizabeth went on to graduate from college, got married, and had three children. None of whom ever knew of her secret regime. They would see their mother disappear into her room each day at 5:30, in the evenings, but never knew what she was doing there.

She was always strict with her diet and exercise while travelling widely. She lived a healthy life to the age of 74, with no complications.

So, Elizabeth Hughes demonstrated that it was her attitude to life, her ‘inner conductor’ of her choices, that guided the rhythm of her life. No one else directed her.

Probably, many people with diabetes feel the oppressiveness of the cage of chronic illness, the diet and insulin dependence. Yet, Elizabeth found insulin liberating. Most of all, she found it to be a miracle substance which transformed her life.

Therefore, much can be learnt from reflecting on the history of people living with diabetes, and how current individual reflection influences the possibility for leading a healthy life with diabetes.

Accounts of this marvellous discovery can be found in two highly recommended books by the renowned Canadian historian, Michael Bliss – ‘The Discovery of Insulin’ and ‘Banting – A Biography’. Anyone who reads these will never see insulin in the same light again.

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Please contact Noy Pullen if you would like more information on her resources: [email protected] or 072 258 7132.

AGENTS FOR CHANGE IS A DIABETES SOUTH AFRICA PROJECT

MANAGED BY NOY PULLEN