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(9) Diabetes

Treatment with insulin

Insulin was discovered by Frederick Banting and Charles Best in the summer of 1921. The work was carried out in the Physiology Department of Toronto University while most of the staff was on their holidays. The first human to be given insulin was a 14- year-old boy named Leonard Thompson who was dying of diabetes in Toronto General Hospital.

 This was an historic event, representing the beginning of modern treatment for diabetes. It was then up to the chemists to transform the production of insulin into an industrial process on a vast scale.

When Dr Robin Lawrence heard the news, he was in Florence waiting to die from diabetes. Instead he lived on and, with H. G. Wells, went on to found the British Diabetic Association, and now called Diabetes UK. Insulin treatment replaces the insulin normally produced by the pancreas gland, which becomes severely deficient in most people whose diabetes develops before they are 30 years old. In people in whom diabetes develops later in life, the deficiency of insulin is much less marked and forms of treatment other than insulin injections usually work for some time, though usually not indefinitely.

Insulin still has to be given by injection because at present it is inactivated if taken by mouth. Research is being carried out on inhaled and oral (by mouth) insulin, although neither treatment is available yet. About a quarter of all people with diabetes are treated with insulin. Virtually everyone who develops diabetes when they are young needs insulin from the time of diagnosis.

People diagnosed in later life may manage quite satisfactorily for many years on other forms of treatment but eventually many of them will need insulin to supplement their diminishing supply of insulin from their pancreas.

Everyone dreads the thought of having to inject themselves but the modern needles and syringes or insulin pens are so good that in nearly all cases this fear disappears after the first few injections, and daily injections become no more of a hassle than brushing your teeth. People on insulin still have to watch what they eat.

However, healthy eating is only part of the treatment. Being the right weight and getting enough exercise is also very important. They usually affect people on insulin but can happen to those taking certain tablets. It is the fear of hypos that prevents some people from controlling their blood glucose tightly. Diabetes care teams are often criticized for not giving people who are newly diagnosed enough information on hypos.

 

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