Insulin: Moments in history

The isolation of insulin by Banting and Best in 1922 was a historic event of life-saving importance. Thousands of individuals doomed to die of type I diabetes were saved. The inspiring story of insulin continued to grow and evolve with the development of PZI, NPH, and lente insulins. The advent of production of human insulin from recombinant DNA brought an end to the extraction of insulin from animal pancreas. Modification of the amino acid sequences of insulin led to new forms of fast-acting insulin, such as lispro, aspart, and glulisine, and to long-acting insulins like glargine and detemir. The technology of insulin pumps advanced from large, cumbersome equipment to present-day devices no bigger than a hand calculator. The accuracy of implantable glucose sensors improved progressively, culminating in the approval of devices that will soon exert reliable feedback control of insulin pumps. Transplantation of the pancreas offers a cure for type I diabetes, and the development of islet cell transplantation continues. It is now appreciated that islet cells regenerate in the normal pancreas, and islet cell neogenesis agents have been identified and may eventually contribute to the reversal of diabetes.