Adrienne Banh

Comm 100 3PM

Floss, James

16 October 2017

History of Insulin

SPECIFIC PURPOSE: To inform my audience the major historical developments of insulin. 

CENTRAL IDEA: The vast improvement of insulin developed through the 19th, 20th, and 21st centuries.

ORGANIZATIONAL PATTERN: Chronological

INTRODUCTION

Attention and interest: Who is she? She's rather a very close friend of mine. Some may even say we look alike. Truthfully, she's a friend who not only saved my life, but also the lives of many who are diagnosed with diabetes. Her name is Insulin.

Reveal topic: Diabetes, a definition provided by the U.S. National Library of Medicine, explained that it "is a disease in which your blood glucose, or blood sugar, levels are too high." From the early findings of diabetes, many human beings were brutally perished due to an unknown cause—a disease that would turn an excruciating life expectancy within three weeks said Jim Turner, a diabetes educator. The unknown cause brought upon the discovery of insulin. Through the doctors and nurses I've met in the hospital, they've explained that insulin is a hormone that releases into the bloodstream in the body pertaining to the endocrine system, where glands, or organs regulate blood sugar levels. Of December 2016, a diabetic author Ginger Vieira, explained that approximately 57 million people living with Type 1 diabetes are encountering death due to the unavailability of insulin. Without the vital medication, one cannot sustain the ability to live.

Credibility and Goodwill: Although, as an individual diagnosed with Type 1 diabetes for thirteen years, carrying around an insulin pump since my childhood, I am educated with the fundamental function of insulin with the aid of Dr. Vargas, my endocrinologist—a doctor who specializes in restoring a patient's hormones. Additionally, I would attend diabetic workshops and conventions whenever Rady Children's Hospital provided me the opportunity. However, I have evermore ignited myself an abundant curiosity as to where the origins of insulin begun and how insulin improved throughout the centuries.  

Preview statement: With this interest, I would like to share with you the significant findings of insulin throughout the 19th, 20th, and 21st centuries.

(transition: Let's start with the 19th century.)

BODY

I. The many vital discoveries of insulin shed its light in the 19th century.

a) In 1869, Paul Langerhans stumbled on cells that produce insulin.

i) While conducting a lab in the field of pathology, he came across the pancreatic islets, or what is now named after his discovery, the 'Islets of Langerhans.'

(1) The 'Islets of Langerhans' are tiny clusters of cells that disperse through the pancreas, according to the Diabetes Research Institute Foundation.

(2) These pancreatic islets contain beta cells.

(3) As explained by Diabetes.co.uk, a health platform publishing daily information on managing diabetes, said "beta cells are unique cells in the pancreas that produce, store and release the hormone insulin."

(4) Additionally, a purpose of an pancreas as provided by Columbia University Medical Center explained that it is "an endocrine function that regulates blood sugar."

(5) However, the unknown function of the islet discovered by Langerhans will remain a mystery until another few years.

ii) Although, Langerhans made a remarkable contribution in the beginning of the vast searchings for understanding diabetes, Bridget Montgomery, The Diabetes Council publisher of the recent article "From Death to Life: The Discovery of Insulin," stated that "it still took some time to understand the functioning of the pancreas."

b) However, in 1889, the incredible study was expanded even further by a German researcher, Oscar Minkowski and his partner, doctor Joseph von Mering.

i) Medical researchers still had challenges as to where the sudden disease stumbled upon and how to cure it; however, Minkowski and Mering made their scientific debut.

(1) Both conducted an experiment in which they removed the pancreas of a dog.

(a) Author, Montgomery, mentioned that the two doctors removed the pancreas from the body of the dog, which resulted in the dog contracting diabetes.

(b) But she stated when the doctors "surgically tied off the duct in which the pancreatic juices flowed, the dog only developed some minor digestive issues, but not diabetes."

(c) Furthermore, not only the function of the pancreas is to regulate blood sugar levels but to also aid the digestive system.

(d) This discovery came to one of the major significant events of history; the two skilled doctors who unleashed an opening to understanding insulin. 

c) Despite the fact that, this was only the beginning of the incredible finding, many people still struggled with the hardships of diabetes.

i) The only way individuals could've adapted without the treatment was to enable a strict diet and to wait patiently.

ii) However, the longer a person waits without insulin, Centers for Disease Control and Prevention acknowledged that "[w]hen there isn't enough insulin or cells stop responding to insulin, too much blood sugar stays in [the] bloodstream, which over time can cause serious health problems, such as heart disease, vision loss, and kidney disease."

(Transition: Now that I've shared the significant findings of insulin in the 19th century, let's move on into the 20th century.)

II. The many vital discoveries of insulin shed its light in the 20th century.

a) In 1921, doctors Frederick Banting and Charles Best found a approach of removing the pancreas of many laboratory dogs to isolate the cells that make insulin.

i) From conducting this trial, they would then attempt to produce pure insulin to regulate human blood sugar levels.

(1) In Vice President for Research of The Ohio State University, Alfred B. Garret''s 1963 book, The Flash Genius, contributed that the exploration took the two doctors ninety-two dogs to encounter the disease.

(2) In addition to the experiment concluding that the removal of the pancreas diagnosed the dog with diabetes, they also discovered that the dog's blood glucose level increased, and its body weakened and dehydrated—explained by Montgomery.

(3) The reason for the inclination of the blood glucose levels was a result of a molecule called ketones; Linda Thrasybule, author of an September 2012 article, "People Dying of Diabetes Who Never Knew They Had It, Study Finds"proclaimed that "if ketone levels climb too high, they can poison the body, causing chemical imbalances that can lead to coma, or death."

(4) Garrett stated, with the use of the frozen combination of salt and water from the pancreas they've discovered—both of the doctors were able to maintain the dog's blood sugar level and making the dog gain a sufficient amount of weight which allowed it to become stronger.

(5) However, due to the inadequate supply of the extract, the dog's blood sugar levels skyrocketed, leading to its death.

(6) The extract injected into the dog was now called isletin.

(7) Due to the short supplies of dog they had left, they needed to attain a rather larger supply of pancreatic isletin; as a result they decided to obtain a larger amount of supply of pancreas from a cow—said author, Garrett. 

ii) In the following year of 1922, biochemist Bertram Collip made the powerful change in purifying insulin.

(1) Both, Banting and Collip injected the substance in their body; as a result, they experienced their blood sugar levels declining, making them feel hungry and nauseated.

(2) The Chemical Heritage Foundation, a headquarter of preserving the history of scientific adventures, explained that victorious discovery led scientists to now focus on their first patient who happened to be a young boy named Leonard Thompson.

(3) The child was on the verge of death, but insulin saved his life—the injection was truly a success.

(4) Therefore, he was able to live—regaining his weight and strength—informed by PBS journalist, Dr. Howard Markel.

iii) This monumental legacy opened many doors for numerous scientists to spread the treatment for human beings diagnosed with the deadly disease.

iv) Within 60 years, an even more purified form of insulin goes on the market worldwide by the company, Eli Lilly.

(1) From that point on, they marketed a newer type of insulin that would alter change in absorbing, metabolising and excreting—as provided by the American Diabetes Association.

(2) This new type was the new trademark called Humalog.

(3) A vile that would also nourish and sustain the many lives, including myself since diagnoses.  

(transition: Now that I've discussed the many significant findings of insulin in the 19th and 20th century, let's finalize with the 21st century.)

III. The many vital discoveries of insulin shed its light in the 21st century.

a) Rather than constantly waiting to warm insulin for every syringe injection, the modern era has now allowed diabetes to inject insulin through the touch of the insulin pen and insulin pump.

i) The convenience of having the two creates a platform for many diabetes individuals.

ii) The intake for both are quick and efficient; it's literally on the hip your body. 

b) In 2015, doctor Edward Damiano created an invention called the iLet in which the device is able to replicate a pancreas that can simultaneously deliver insulin and glucagon every five minutes.

i) My endocrinologist once educated me the function of a glucagon, it is an injection to prevent my blood sugar from dropping. 

ii) Obtaining a glucagon kit brings many responsibilities such as constantly carrying it around my backpack and if I were to faint, it would cause severe problems not only to myself but for loved ones as well.

iii) Damiano expressed that having a pump that simultaneously injects insulin and glucagon can benefit diabetes from controlling hypoglycemia—low blood sugar levels, and hyperglycemia—high blood sugar levels.

iv) The company hopes to fulfill their test trial in 2017.

CONCLUSION

Signal the end: Before I end my thought, I would like to remind you how insulin has improved throughout centuries:

Review main points: The significant findings of insulin has strongly developed through the 19th, 20th, and 21st centuries.

Ending "kicker": Although insulin is only a temporary diabetic treatment, it has given me the opportunity to live longer with little pain and discomfort. I hope one day there will be a cure that can eliminate diabetes and change the world for the better. But as of right now, I have a close friend that will always stick by my side.

Bibliography

Association, American Diabetes."The History of a Wonderful Thing We Call Insulin" Diabetes Stops Here, 21 Aug. 2012, http://diabetesstopshere.org/2012/08/21/the-history-of-a-wonderful-thing-we-call-insulin/.

Bos, Carole. "Insulin - A Life-Saving Discovery." AwesomeStories.Com, 19 Feb. 2014, https://www.awesomestories.com/asset/view/Insulin-A-Life-Saving-Discovery0.

Centers for Disease Control and Prevention. Diabetes: What's Insulin Resistance Got To Do with It? | Features & Spotlights | Resources & Publications | Diabetes | CDC. 11 Oct. 2017, https://www.cdc.gov/diabetes/library/spotlights/diabetes-insulin-resistance.html.

Colorado State University. "Functional Anatomy of the Endocrine Pancreas." Hypertexts for Biomedical Sciences, http://www.vivo.colostate.edu/hbooks/pathphys/endocrine/pancreas/anatomy.html. Accessed 15 Oct. 2017.

Dalarna University. "Insulin Pump Affects Person's Quality of Life, Diabetes Study Shows." News-Medical.Net, 27 Mar. 2013, https://www.news-medical.net/news/20130327/Insulin-pump-affects-persons-quality-of-life-diabetes-study-shows.aspx.

Diabetes.co.uk. Beta Cells - What They Do, Role in Insulin. http://www.diabetes.co.uk/body/beta-cells.html. Accessed 15 Oct. 2017.

"Frederick Banting, Charles Best, James Collip, and John Macleod." Chemical Heritage Foundation, 1 June 2016, https://www.chemheritage.org/historical-profile/frederick-banting-charles-best-james-collip-and-john-macleod.

Garrett, Alfred Benjamin. The Flash of Genius. Princeton, N.J., Van Nostrand, 1963.

Howard Markel. "How a Boy Became the First to Beat Back Diabetes." PBS NewsHour, 11 Jan. 2013, http://www.pbs.org/newshour/rundown/how-a-dying-boy-became-the-first-to-beat-diabetes/.

Landers, Mary. "THE PAST AND FUTURE OF DIABETES: [HOME Edition]." Savannah Morning News; Savannah, Ga., 13 Jan. 2000, p. 1B. ProQuest, https://search.proquest.com/usnews/docview/381740208/abstract/2097ACB41E3347E0PQ/1.

Mestel, Rosie. "Booster Shots ROSIE MESTEL; Timeline Shows the Trials and Errors of Treating Diabetes: [HOME EDITION]." Los Angeles Times; Los Angeles, Calif., 3 June 2002, p. S.2. ProQuest, https://search.proquest.com/usnews/docview/421909044/abstract/8CA4DA7F394E4158PQ/1.

Montgomery, Bridget. From Death to Life: The Discovery of Insulin. 24 Sept. 2017, https://www.thediabetescouncil.com/from-death-to-life-the-discovery-of-insulin/.

Nobel Lecture. Frederick G. Banting - Nobel Lecture: Diabetes and Insulin. 15 Sept. 1925, https://www.nobelprize.org/nobel_prizes/medicine/laureates/1923/banting-lecture.html.

Petit, William A., and Christine A. Adamec. The Encyclopedia of Diabetes. Facts on File, 2002.

Professor David Fankhauser. Pancreas and Islets of Langerhans — Science Learning Hub. 2011, https://www.sciencelearn.org.nz/images/1001-pancreas-and-islets-of-langerhans.

Rosie Cotter. "Big Picture." Big Picture, https://bigpictureeducation.com/history-insulin. Accessed 14 Oct. 2017.

THE MNT Editorial Team. "The Discovery Of Insulin - How Was Insulin Discovered?" Medical News Today, https://www.medicalnewstoday.com/info/diabetes/discoveryofinsulin.php. Accessed 15 Oct. 2017.

The National Institute of Diabetes and Digestive and Kidney Diseases, et al. "Prediabetes & Insulin Resistance | NIDDK." National Institute of Diabetes and Digestive and Kidney Diseases, https://www.niddk.nih.gov/health-information/diabetes/overview/what-is-diabetes/prediabetes-insulin-resistance. Accessed 14 Oct. 2017.

Thrasybule, Linda, et al. "People Dying of Diabetes Who Never Knew They Had It, Study Finds." Live Science, 27 Sept. 2012, https://www.livescience.com/23006-diabetes-deaths-undiagnosed-complications.html.

U.S National Library of Medicine. Diabetes. https://medlineplus.gov/diabetes.html. Accessed 14 Oct. 2017.

Vieira, Ginger. "Insulin for All: How Many Diabetics Are Without the Insulin They Need to Live" Diabetes Daily, 10 Nov. 2015, http://www.diabetesdaily.com/blog/2015/11/insulin-for-all-how-many-diabetics-are-without-insulin-they-need-to-live/.