November 14th is World Diabetes Day in honour of the birth in 1891 Sir Frederick Grant Banting, the Nobel Laureate who came up with the idea of insulin.
Before this discovery in 1922, anyone who had Type 1 Diabetes died – unlike people with Type 2 diabetes, T1Ds will progress to coma, organ failure and death in days, weeks or months if they do not take their insulin. Less than 95 years ago, my son would not be here.
The first insulin was taken from dogs, then cows, then pigs. Methods for measuring doses were crude, and it is telling that people surviving 50 years with T1D are awarded a medal.
Synthetic insulin has come a huge way. Type 1s using injections now generally take a long acting insulin that works over around 24 hours, then match a shorter acting insulin to the carbohydrate they eat at mealtimes. Those using insulin pumps have a constant drip of rapid acting insulin. The rate of the drip can be changed for different activities, times of day and types of food.
Changes in insulin delivery make the process of managing Type 1 more intensive and intrusive. But the outcome can be a far higher life expectancy and a delay of complications. Maybe in 50 years they won’t need that medal.
Banting has another legacy or memorial. The Flame of Hope burns in London, Ontario and will continue to burn until a cure is found.
Technology coming down the line will be amazing. By the time my son goes to university he should be able to have a device that does the difficult calculations for him and automatically doses him with insulin and glycogen as needed – an artificial pancreas. My hope burns for this, although the unavailability of existing (and fairly cheap) technology to Type 1 Diabetics is a bucket of cold water on that hope.
And treatment is not a cure. As my son says, an artificial pancreas is just another thing to stick into himself. Should continuous improvement in treatment be prioritised over the search for cure? I don’t know, but I hope against hope another Banting comes along to create a complete step change in Type 1’s lives.