877-944-6131 Email Us

Clinician’s Corner: Insulin

HISTORY:  Frederick Banting (who was an orthopedic surgeon), Charles Best, James Collip, and John Macleod are credited with the monumental discovery of insulin at the University of Toronto in 1922.  The discovery was followed shortly after by the successful large-scale production of insulin in 1923 by the USA company Eli Lilly, resulting from a collaboration between the Toronto researchers and the company’s director of biochemical research George Clowes. Leonard Thompson, a Canadian, was the first human to receive an insulin injection, which was from the pancreas of a dog.  Banting and Best used an ox pancreas as the source of insulin.

Herbert Boyer: Dr Boyer was born in Derry Pennsylvania in 1936 and attended St. Vincent College enrolling in their pre-med program.  One of our local practitioners, Dr. William Aigner a retired family practice physician was a classmate of Dr Boyer’s.  Dr Aigner relates the story that Herb was more interested in genetics, than going to med school.  His classmates questioned his decision.  Herb went on to found Genentech, and in 1978 produced synthetic insulin with the use of a genetically modified bacteria (E. coli).  By the way in 1990, he gave $10 million to Yale, their largest gift ever received.  In 2007 St. Vincent College named the School of Natural Sciences, Biology and Computing after him.  I guess Herb made a good decision not attending med school!

Source:  the insulin used today is “human insulin”.  In days of old sources of insulin were

  • beef: which is 3 amino acids different than human insulin
  • pork: which is 1 amino acid different (less antigenic)
    • (dogs and pigs have the SAME amino acid sequence)
  • these insulins were extracted from the pancreas of cattle and hogs.

Human insulin:

Insulin available today is IDENTICAL to the insulin our pancreas makes.  They are produced by either yeast or bacteria that are “trained” to excrete insulin. Modifications on the insulin molecule, allow for shorter durations, and much longer durations of action.

Insulin can be instituted at ANY point for Type-2 diabetes and should NOT be considered as last resort for treatment of the disease.  Insulin should never be perceived as a “punishment” for a Type-2 diabetic.

Insulin resistance: Insulin resistance occurs when the body does not respond properly to its own natural insulin. Insulin is a hormone in the body that helps convert blood sugar to energy so it can be used by the body’s cells. In individuals with insulin resistance, the pancreas tries to keep up with the demand for insulin by producing and releasing more. Eventually, the pancreas cannot keep up with the body’s need for insulin, and excess sugar builds up in the bloodstream.

Beta cell failure rate:

  • In a healthy adult patient, beta cells fail at about 0.3% per year. (Loss of 3% in 10 years)
  • In an adult patient with Type-2 diabetes, the beta-cell failure rate is 4-6% (loss of 40-60% in 10 years).
  • It is fair to say that if a patient develops Type-2 diabetes early enough in life, if living long enough he will need insulin therapy.
  • We are born with 91million beta cells; at diagnosis of T2DM patients have 45million

Your Thompson Pharmacist has a great deal of expertise in helping you manage your diabetes.  Go Ahead and ASK…  at Thompson Pharmacy it’s all for YOU