First administered in 1922: A century with insulin

On January 23, 1922, a 13-year-old boy received the first insulin shot and survived – a medical revolution. 100 years later, living with diabetes is much easier.

Emil loves to romp around in the playground and to climb the climbing frames. In his free time, the eight-year-old does CrossFit, a kind of climbing course. Only sometimes, when things get too wild, does his insulin pump start vibrating. He then notices how his legs start to tremble: “Whenever you’re playing nicely, the warning comes up ‘Beware of low sugar’ and then you can’t play anymore. It’s stupid then.” But there are also advantages to living with diabetes, says the elementary school student and grins. In class, he is the only one allowed to eat when his blood sugar drops.

When the pancreas goes on strike

This ease of dealing with the disease gives him the insulin pump that accompanies him day in and day out. Emil has type 1 diabetes. This means that he has a genetic predisposition to the fact that the pancreas suddenly stops producing insulin. At the age of four he developed the autoimmune disease: he suddenly lost a lot of weight, was extremely thirsty and was very tired. The diagnosis was clear quickly.

In the 19th century, a diagnosis of type 1 diabetes was still a death sentence. In 1921, Canadian researcher Frederick Grant Banting and his assistant Charles Best were the first to isolate insulin from a dog’s pancreas. A year later, the time had already come: on January 23, 1922, 13-year-old Leonard Thompson, who was then suffering from a life-threatening illness, received the first insulin injection. The success was quickly visible. He recovered and lived another 13 years until he died of pneumonia.

The new drug quickly became known. In Toronto, the first industrial insulin production was established and many children benefited. As early as 1923, Banting and his colleague John Macleod, who played a key role in researching insulin, received the Nobel Prize in Medicine for their achievements.

High-tech medicine gives more security

Long injections and complicated measuring of the blood sugar level are now history. Eight-year-old Emil’s insulin pump is linked to a sensor on his arm. It continuously measures the blood sugar level. The values ​​are transmitted directly to the pump on the abdomen, so that the amount and timing of an injection is automatically calculated and injected into the body via a catheter. At the same time, Emil’s father Timo Gendrullis can use an app to track his son’s values ​​and also call them up retrospectively. “It’s very calming, and the nights have become much quieter,” says Gendrullis.

These precise adjustments using the app and sensor are new to the application. But doctors like the children’s diabetologist Eggert Lilienthal from the University Children’s Hospital in Bochum have high hopes. Because the glucose levels in the blood are much more stable. “I expect that the rate of secondary diseases such as those affecting the eyes, kidneys or nerves will be significantly lower,” says Lilienthal.

Widespread disease type 2 diabetes

Unlike 100 years ago, type 2 diabetes clearly predominates today. It is mainly triggered by diet and lifestyle. There is also a hereditary predisposition, explains the head of clinical research at the St. Josef Hospital in Bochum, Michael Nauck: If the father, mother or siblings of a person suffer from type 2 diabetes, the risk of developing it yourself increases to 50 percent . Around nine million people now suffer from type 2 diabetes and around 400,000 people from type 1.

In type 2, the pancreas only partially stops producing the hormone insulin. Therefore, many patients with a healthy lifestyle, a change in diet and exercise can contribute significantly to a healthy metabolic situation, so that insulin administration is not necessary at all.

New drug brings further progress

Another milestone is treatment with a second type of medication that is administered by injection: so-called GLP-1 receptor agonists, which Nauck played a key role in preparing with his research. In this way, for example, the remaining hormone production of insulin in the pancreas can be stimulated and hypoglycaemia can still be avoided because GLP-1 receptor agonists are only effective as long as the blood sugar is elevated.

In the future, such drugs should also be available as tablets. More type 2 patients can thus do without the annoying pricks and run less risk of complications such as a heart attack or a stroke. Ultimately, it is important that diabetes is diagnosed as early as possible and treated consistently.