Diabetogenic

I was pulled up yesterday for getting things wrong about the discovery of insulin. We were asked in a meeting why World Diabetes Day is celebrated on 14 November, and like the nerdy-goody-two-shoes I am, my hand shot in the air and I was called on.  It was like being in year 8 again.

‘It’s Frederick Banting’s birthday.  Banting, along with Charles Best, is credited with discovering insulin.’

‘Stop,’ I was told. ‘Before you keep getting things wrong.’

I was then given a history lesson and told that while Banting and Best were responsible for isolating insulin, it was actually Edward Albert Schafer who discovered it.

So have Banting and Best been heralded all along for something they didn’t deserve? Was it in fact Schafer who should be credited? Well, no. Not really.

It is true; Schafer – actually Edward Albert Sharpey-Schafer – did have a role in the story of insulin. But so did others. Many, many others.

I couldn’t sleep last night, so searched on our bookshelves for my copy of The Discovery of Insulin. I remember reading it years ago and found the history of the little hormone that could absolutely fascinating. As with many discoveries, it was a combination of years of work by many researchers and also, some luck thrown in!  

It was German medical student, Paul Langerhans, who first identified the clusters of cells – islets – in the pancreas, however could not determine their function.  This was in 1869.

A French physician, Etienne Lancereaux confirmed through his research that the cause of diabetes was something to do with the pancreas – in fact, he published a paper coining the term diabète pancréatique (published in 1877). It is Lancereaux who defined two forms of diabetes.

In 1889, two German scientists found that if the pancreas was removed from dogs, the animals developed symptoms of diabetes – excessive thirst, increased urination, weight loss – and died before long. However, these researches – Oskar Minkowski and Josef von Mering – were unable to find the specific chemical responsible for the elevated glucose levels.

This is where Edward Sharpey-Schafer joins the story. Schafer’s experiments – from as early as 1894 – identified that in people with diabetes there was one chemical missing from the pancreas. In lectures at Stanford University in 1913, he named this chemical ‘insuline‘ taken from the Latin word for island ‘insula‘. (Langerhans, in his 1969 dissertation, had referred to the islets in the pancreas as ‘islands of clear cells’.)

However, someone had already beaten Schafer to it. Belgian clinician and physiologist Jean De Meyer is actually credited with coining the term ‘insulin’ in 1909 where he noted: ‘the internal secretion of the pancreas (not as yet named) and which, if derived, as we believe, from the islets of Langerhans, could be called insulin’. Schafer denied any knowledge of de Meyer’s earlier work.

This was all before Banting and Best, in their experiments, discovered exactly what insulin did and how to isolate the hormone. This was in 1921 and it was this work that led to injecting insulin into dogs with diabetes, and in January 1922, the first insulin injection was given to a person with diabetes.

It is Banting and Best’s work that is responsible for me being alive today.

As with any good story, there is controversy and intrigue. Nicolae Paulescu, a Romanian physiologist, is thought by some to have been the real hero in the discovery of insulin. In his experiments, Paulescu showed that a chemical he called ‘pancreine’ clearly lowered blood glucose levels in animals. However, in 1916 when Bucharest was occupied, his experiments were abruptly stopped and he was unable to publish the results of his experiments until August 1921.

I am Australian, but that doesn’t mean I think it’s okay to discriminate against people from other countries.

I am a woman, but that doesn’t mean that I think it is okay to be sexist to men.

I am of no particular faith, but that doesn’t mean that I go around discriminating against people who are.

I am a mother, but that doesn’t mean I think it’s okay to be nasty to women who are not.

I am a straight woman, but that doesn’t mean I discriminate against anyone who is of a different sexual orientation.

I have type 1 diabetes, but that doesn’t mean I stigmatise those with type 2 diabetes.  

So when I saw this initiative from JDRF, I immediately ‘blue-ified’ a photo and stuck in on Twitter and Facebook and Instagram. Because it’s true. T1D DOES look like me.

And then I was kinda baffled at the storm that started brewing because this campaign was considered to be dividing the community.

I had to stop and think about that for a moment. As someone who is rather vocal about how destructive the ‘type wars’ can be, I wondered if this campaign was also contributing to the ‘us and them’ rhetoric.

But I really, really struggled to understand why there was the angst.

There are differences between the diverse types of diabetes. But that absolutely does not mean one is better or worse than the other. It doesn’t mean that one is more serious than the other. It doesn’t mean that one is more deserving of sympathy, or research funds, or attention.

Diabetes awareness is important for us all. And this campaign is brilliant in showing that type 1 diabetes doesn’t have a ‘look’ or a poster child. In fact, it shows that type 1 diabetes is not all about children, which is often how it seems. It presents the diversity of the community and it shows that assuming everyone is the same is a mistake.

T1D looks like me. And like 118,000 other people around Australia and a hell of a lot more around the world.