A Century-long Journey of Type 1 Diabetes Management: From Insulin to …???
Can you answer this question mark in the title? What is the next product coming in the market for reversing or managing type 1 diabetes?

The history of type 1 diabetes (T1DM) is a longstanding story. However, its management became possible only after the discovery of insulin by Frederick Banting and Charles Best in 1921. With this, scientists started developing the hopes to cure this disease. Unfortunately, this goal is yet to be accomplished. This article gives a tour of the various advancements in managing T1DM and how still there is no cure for this perilous disease.
Insulin: The First Weapon to Fight T1DM

The discovery of insulin was not by chance, it was a very well-thought science. The cascade goes as follows:

1889: Joseph von Mering and Oskar Minkowski observed that removing the pancreas from dogs developed diabetes in them, followed by their death shortly.

1910: Sir Edward Albert Sharpey-Schafer projected that the lack of a specific chemical produced by the pancreas is responsible for the development of diabetes. He then named it 'insulin'.

1921: Frederick Banting and Charles Best extracted the pancreatic islet cells from healthy dogs and presented them into the dogs with diabetes which reversed the diabetic condition. This was a stepping stone towards the management of T1DM by the discovery of the hormone, insulin.

Then with the help of two other scientists, then purified insulin extracted from the cow’s pancreas and marked the first treatment option for diabetes.

Finally, in January 1922, this research was translated to humans when 14-year-old Leonard Thompson received an insulin injection to treat his diabetes. This helped him survive for 13 more years and eventually, he died of pneumonia.

And the journey continues this way…

1930s: Introduction of Insulins with longer duration of action.

1936: Sir Harold Percival Himsworth published his research which helped to understand the difference between type 1 diabetes and type 2 diabetes.

1978: Development of Humulin, the first human-based insulin, identical to human insulin in structure.

1986: Insulin pen (prefilled syringes) delivery system was available. This lead to a safe and convenient way to deliver the required dose of insulin.

1990s: Invention of external insulin pumps, which could provide healthier results, more flexibility, and easier treatment management.

1996: Lispro, the first short-acting insulin (onset of action = 15 minutes and duration of action = 2-4 hours), entered the market.

Where We Are Today

Insulin is still the only therapy used to manage type 1 diabetes. Islet transplant is also considered; however, it has to be accompanied with immunosuppressant drugs and still there is difficulty in maintenance of insulin independence; plus, Cadaveric islet transplantation needs multiple donors and is non-affordable to the common man. Extensive research is going on for immune-related therapies; unfortunately, with nothing in the market yet for patient us.

We are working towards a permanent solution to prevent and reverse type 1 diabetes and looking forward to eradicating this disease.

Type 1 to Type None!

References
  1. Vecchio I, Tornali C, Bragazzi NL, Martini M. The Discovery of Insulin: An Important Milestone in the History of Medicine. Front Endocrinol (Lausanne). 2018; 9:613.
  2. Subramanian S, Baidal D, Skyler JS, Hirsch IB. The Management of Type 1 Diabetes. [Updated 2016 Nov 16]. In: Feingold KR, Anawalt B, Boyce A, et al., editors. Endotext [Internet]. South Dartmouth (MA): MDText.com, Inc.; 2000-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK279114/
  3. Raz I., Ziegler A.G., Linn T. et al. Treatment of Recent-Onset Type 1 Diabetic Patients With DiaPep277: Results of a Double-Blind, Placebo Controlled, Randomized Phase 3 Trial. Diabetes Care. 2014; 37:1392-1400.
  4. Kühtreiber W.M., Tran L., Kim T. et al. Long-term reduction in hyperglycemia in advanced type 1 diabetes: the value of induced aerobic glycolysis with BCG vaccinations. npj Vaccines. 2018; 23:1-14.


5 comments:

  1. Not much has happened in this field of T1DM. Need an effective vaccine for its permanent eradication. Wishing you all success!!

    ReplyDelete
    Replies
    1. Thank you very much, Dr Sharma, for the motivation. Let’s make it happen

      Delete
  2. Thanks for being an inspiration for future students in research Mam & many many wishes for the Success !

    ReplyDelete

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