What is type 1 diabetes?
Type 1 diabetes mellitus is a disorder affecting glucose metabolism. Glucose cannot enter cells due to a lack of the hormone insulin. In people with diabetes, insulin-producing cells in the pancreas are destroyed.
Unused glucose accumulates in the blood and the urine. Fats are used as an alternative energy source, which leads to a build-up of ketones in the blood that may eventually cause convulsions and diabetic coma. Treatment is based mainly on taking insulin by injection or pump to maintain normal blood-sugar levels.
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This is an excellent choice for busy parents of kids with type one diabetes.
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History of diabetes treatment
We list important milestones in the history of type 1 and type 2 diabetes treatment.
1916
Nicolae Paulescu, a Romanian, develops a pancreatic extract which normalizes blood sugar levels when injected into dogs. His term for insulin is pancreatine.
Early containers of insulin from the University of Toronto
Elizabeth Hughes, left, one of the first to be treated
Diabetes monograph by John Macleod
Frederick Banting, right, and his assistant Charles Best
Frederick Banting's lab at the University of Toronto
1921
Frederick G. Banting and student Charles Best, advised by John MacCleod at Toronto University, extract insulin from animal pancreases. James Collip purifies the extract so that it can be used in humans.
Dr. Joseph Gilchrist, a friend of F. G. Banting, is the first human to receive the pancreatic extract manufactured by Banting and Best. It is administered orally and has no beneficial results.
1922
Leonard Thompson, 14, is the first person in the world to be injected with insulin. The first injection on January 11 has little effect. A second injection of purer insulin is injected om January 23 and Thompson improves rapidly. He lives for 13 more years.
Insulin made commercially available in Great Britain (the first country in which this is done) from May 16.
Jim Havens a diabetic patient under the care of Dr. J. R. Williams in Rochester, is the first person in the United States to receive extract on May 22.
Charlotte Clark, a patient at the Toronto General Hospital, is the first person to receive insulin for surgery on July 10. Teddy Ryder, a five-year old diabetic patient from New Jersey, arrives in Toronto for treatment.
Elizabeth Hughes Gossett, a U.S. citizen and Banting's most famous patient. Weighing just over 50 lbs at age 14, Elizabeth arrives in Toronto with her mother on August 16, 1922 and begins receiving insulin from Frederick G. Banting. She receives over 42,000 insulin shots before she dies in 1981.
Elsie Needham is brought back to consciousness from a state of coma with the use of insulin in October 1922.
August Krogh begins experimenting with and producing insulin in Denmark.
1923
Frederick G. Banting and John Macleod are awarded the Nobel Prize in Physiology or Medicine for their discovery of insulin treatment for diabetes.
Eli Lilly and Company begin commercial production of insulin.
1926
Insulin is patented or trademarked in countries 44 countries world-wide.
1934
R.D. Lawrence and author H.G. Wells co-found the Diabetic Association 1934. Its goal is for diabetes patients in the UK to have access to insulin, whatever their financial situation.
1940
The American Diabetes Association (ADA) is founded.
Miles Laboratories develop Clinitest, the first convenient tablet test for detection of reducing sugars (glucose is a reducing sugar) in urine.
1949
Rachmiel Levine discovers that insulin works like a key, transporting glucose into cells.
Becton Dickinson and Company begin production of a standardized insulin syringe designed and approved by the ADA.
1959
Solomon Berson and Rosalyn Yalow measure insulin in the blood using radioimmunoassay technology. They identify insulin dependent
(type 1) and non-insulin-dependent
(type 2) diabetes. Yalow is later a co-winner of the 1977 Nobel Prize in Physiology or Medicine (together with Roger Guillemin and Andrew Schally) for development of the radioimmunoassay (RIA) technique.
1961
Eli Lilly and Company introduce Glucagon, an injectable treatment for severe hypoglycemia.
1964
Miles Laboratories develop Dextrostix, the first test strip for glucose in blood.
1966
The first successful pancreas transplant is performed at the University of Minnesota Hospital.
1969
Dorothy Hodgkin, five years after receiving the Nobel Prize in Chemistry in 1964, decipher the three-dimensional structure of insulin using X-ray crystallography.
Ames Diagnostics create the first portable blood glucose meter in.
1973
U100 insulin is introduced. The availability of this single concentration and with insulin syringes marked with only a U100 scale, there should be a reduction in dosing errors.
1976
Researchers in the U.K. detect antibodies to islet cells in people with type 1 diabetes, adding weight to the argument that type 1 diabetes is caused by an immune system attack on pancreatic islet cells.
1978
Researchers at the City of Hope National Medical Center in Duarte, California, and Genentech, Inc., in San Francisco, induce E. coli bacteria to produce insulin identical to human insulin.
1979
The National Diabetes Data Group develops a new diabetes classification system: 1) insulin-dependent or type 1 diabetes, 2) non-insulin-dependent or type 2 diabetes, 3) gestational diabetes, and 4) diabetes associated with other syndromes or conditions.
1982
A 64K autoantibody is discovered and is found to be associated with type 1 diabetes.
1986
The National Diabetes Data Group reports that type 2 diabetes is more common among African Americans, Mexican Americans, and Native Americans than among Caucasians. Fifty percent of all Pima Indians in Arizona over the age of 35 have diabetes -- the highest rate in the world.
1988
Massimo Trucco, University of Pittsburgh, working with John A. Todd, uncover a genetic abnormality leading to type 1 diabetes. Ninety-six percent of the patients in their study with diabetes do not carry an aspartic acid in codon 57 of their HLA-DQ beta-chain. These results indicate that there is more than a 100-fold risk of developing diabetes with this particular genetic abnormality. This was a large step in discovering the predisposition to type 1 diabetes.
Gerald Reaven in the 1988 Banting Lecture advances the theory that central obesity (male-type or apple-shaped obesity), diabetes and hypertension (high blood pressure) have a common cause in insulin resistance and impaired glucose tolerance. At first called syndrome X, the symptoms are now known as the metabolic syndrome.
1990
GLUT-4 is discovered to distribute glucose into muscle and fat cells.
1992
Daniel Kauffman, Mark Atkinson, and Noel MacLaren identify the protein that is first targeted as the body’s immune system attacks and destroys the beta cells that manufacture insulin in the pancreas. This protein, GAD, or glutamate decarboxylase, is an important enzyme involved in cellular communication in the brain and pancreas. The immune system’s attack on GAD triggers a progressive autoimmune response that leads to diabetes.
1995
T helper cells are discovered in type 1 diabetes. T helper 1-like cells actively promote diabetes, while T helper 2-like cells invade the islets but do not prevent or promote disease.
2000
Researchers at the University of Alberta in Edmonton, Canada report on the success of an islet cell transplant technique known as the Edmonton protocol.
2006
The first inhaled form of insulin to be FDA approved for adults with type 1 or type 2 diabetes, Exubera, is found to be just as effective as short-acting insulin injections in controlling blood glucose levels.
Compiled by David Hay Jones
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