In 1921, a medical discovery changed the future of millions of people living with diabetes. Insulin transformed a once devastating diagnosis into a manageable condition and opened a new chapter in modern medicine. On World Diabetes Day, November 14, its discovery offers a story of scientific breakthroughs, teamwork, and a Nobel Prize that raised questions about who deserved the credit.
Before insulin, diabetes meant a very different future
At the beginning of the 20th century, doctors had few effective ways to treat severe diabetes. Patients, particularly children with Type 1 diabetes, often faced a grim prognosis. Some were placed on extreme low-calorie diets that could prolong life temporarily but left them dangerously weak.
Scientists understood that the pancreas played a central role in diabetes. They had not yet found a reliable way to extract the substance that regulated blood sugar without destroying its effectiveness. That challenge drew researchers from different backgrounds into a race to find a treatment. The breakthrough would come at the University of Toronto in Canada.
The experiments that changed medicine
In 1920, Canadian surgeon Frederick Banting developed an idea for extracting a pancreatic substance that might help control diabetes. He approached John James Rickard Macleod, a Scottish physiologist and expert in carbohydrate metabolism at the University of Toronto. Macleod initially had doubts about Banting’s proposal. Nevertheless, he provided laboratory space and assigned research student Charles Best to assist him.
Their experiments began in May 1921. Banting and Best worked to obtain pancreatic extracts that could lower blood sugar in diabetic dogs. The work involved repeated setbacks, but the results gradually became more promising.
Macleod later joined the effort more closely and brought in biochemist James Bertram Collip. His expertise proved essential in purifying the extract so researchers could safely test it in humans.
The first human treatment, given to 14-year-old Leonard Thompson in January 1922, produced disappointing initial results. The extract was not pure enough. After further work by Collip, Thompson received another injection on January 23, 1922. His blood sugar levels fell dramatically, marking a turning point in diabetes treatment.
Insulin was no longer only a laboratory possibility. It was becoming a life-saving treatment.
Why the 1923 Nobel Prize caused controversy
In 1923, the Nobel Assembly at the Karolinska Institute awarded the Nobel Prize in Physiology or Medicine to Banting and Macleod for the discovery of insulin.
The decision caused tension because four researchers had played important roles in the breakthrough. Banting believed Best deserved recognition for their early experiments. Macleod, meanwhile, considered Collip’s work on purification essential to making insulin suitable for human treatment.
The Nobel committee selected two recipients, not four. The decision intensified disagreements over how the discovery should be credited.
Banting responded by sharing his half of the prize money with Best. Macleod also shared his portion with Collip. Their actions acknowledged the contributions of colleagues who had not received the Nobel distinction.
The story is more complicated than a simple dispute over who discovered insulin. Banting proposed the experimental approach, Best helped conduct the early experiments, Macleod provided scientific expertise and laboratory support, and Collip developed a purified extract suitable for human use. Each contribution helped turn an idea into an effective treatment.
A discovery that continues to shape lives
Insulin soon moved from experimental treatment to large-scale production. In 1923, the University of Toronto licensed the technology to support wider manufacturing, helping make the treatment available to more patients.
Banting, Best, and Collip also sold their insulin patents to the University of Toronto for one dollar each. Banting famously expressed the belief that insulin belonged to the world, reflecting the hope that the treatment would benefit people beyond the laboratory.
More than a century later, insulin remains essential to the treatment of many people with diabetes, especially those with Type 1 diabetes. It does not cure the condition, but it has transformed its management and saved millions of lives.
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