100 years of insulin – where to from here?

Posted: 11th January 2022

On this day 100 years ago, 14-year-old type 1 diabetes patient Leonard Thompson lay dying at Toronto General Hospital.

Weighing only 29 kilograms, Leonard was in a ward with 50 other diabetic children. With no treatment available, many already lay in a coma, with grieving relatives by their sides, as they awaited inevitable death.

But just hours from slipping into a coma himself, Leonard was selected for an experimental treatment – the injection of a hormone called insulin, purified from the pancreas of cattle.

Insulin regulates the body’s use of glucose. It is produced by beta cells in the pancreas, contained within small clumps of cells called islets. In type 1 diabetes, beta cells are mistakenly attacked and destroyed by the immune system.

Following a remarkable recovery, Leonard Thompson’s treatment became the new standard of care for people with type 1 diabetes worldwide.

The discovery of insulin is one of medical research’s great triumphs. But 100 years on, how are scientists progressing the next breakthrough for those living with type 1 diabetes?

SVI Director and internationally leading diabetes researcher, Professor Tom Kay, explains where SVI’s cutting-edge diabetes research stands today.

“We’re taking a multi-pronged approach to both treating and preventing the disease, so as to make the greatest possible impact,” says Tom.

“SVI plays a pivotal role in the Australian Islet Transplantation Program, in which we treat people with unstable and difficult-to-control type 1 diabetes. We have perfected the isolation of insulin-producing islets from organ donors, for transplant.”

“Our scientists also study the precise mechanisms by which the destruction of beta cells occurs, and work to find ways to prevent this from happening in the first place.”

The SVI-led clinical trial dubbed “BANDIT” (baricitinib in new onset type 1 diabetes), is investigating whether baricitinib – a drug used to treat rheumatoid arthritis – can protect insulin producing beta cells from immune attack.

“Our aim is to retain those beta cells still present when type 1 diabetes is first diagnosed, and prolong the body’s own production of insulin,” says Professor Helen Thomas, BANDIT co-investigator and Head of SVI’s Immunology & Diabetes Laboratory.

“If this trial, supported by JDRF Australia and JDRF International, proves successful, people with type 1 diabetes could be significantly less dependent on insulin treatment. That would herald a massive change in type 1 diabetes care.”

“We’ve just finished recruiting for the BANDIT trial. We are optimistic that, with the support of our generous trial participants and the expertise of our clinical collaborators, we will see positive results,” says Helen.

In other work, SVI researchers are investigating:

  • How beta cells die
  • What triggers the immune system to initiate the disease and how it could be reprogrammed
  • New methods of replacing beta cells

“We are more and more hopeful of being able to transform the lives of people diagnosed with type 1 diabetes in the future,” says Tom. “I’m certain we won’t have to wait another 100 years for the next big breakthrough.”

To find out more about current research into type 1 diabetes, view a video of Professor Helen Thomas HERE. 

IMAGE: Islets in the pancreas contain the beta cells that make insulin.