How Was Diabetes Treated Before Insulin: Historical Approaches to Management

Before insulin, diabetes was managed with harsh diets and theories but no effective treatment existed until its discovery.

Historical Treatments of Diabetes Before Insulin

Before the life-changing discovery of insulin, managing diabetes was a daunting challenge, with healthcare providers relying on less effective, often harsh dietary measures and a variety of medical theories to treat patients.

Dietary Regulation and Starvation Diets

In the early 20th century, Frederick Allen proposed the starvation diet as a treatment for diabetes, prompting healthcare providers to prescribe highly restricted diets with minimal carbohydrate intake.

This practice, developed around 1915, involved calorie restriction to the extent that it was often referred to as a “starvation diet.” While this method could extend the lives of patients with diabetes, particularly those with type 1 diabetes, it was by no means a cure and often led to severe undernourishment.

Early Scientific Discoveries and Theories

The connection between the pancreas and diabetes was first established in the late 19th century by Oskar Minkowski and others through experimental research.

They noted that dogs developed diabetes symptoms when their pancreas was removed.

Despite these early scientific discoveries, including the recognition of glycosuria—glucose in the urine—as a sign of diabetes, effective treatments were elusive until the early 1920s.

Treatment Techniques and Clinic Practices

Various treatment techniques were applied in clinics before insulin, including exercise and dietary adjustments recommended by healthcare providers and dieticians.

Monitoring of glycemia, or blood glucose levels, was primitive, and glycemic control was poor at best.

Fasting and severe restriction of carbohydrates were common practices, alongside theories on protein management.

Exercise was recommended to improve overall health and, ostensibly, to manage glucose levels.

Yet, these techniques provided limited relief, and the prognosis for patients with diabetes remained poor until the introduction of insulin.

The Pioneering Era of Insulin Discovery

Scientists in a lab, surrounded by test tubes and equipment, working diligently to discover a treatment for diabetes before the era of insulin

The discovery of insulin in the early 20th century was a revolutionary breakthrough that transformed diabetes from a fatal diagnosis to a manageable condition.

This period was marked by groundbreaking research and the collaborative efforts of scientists whose work paved the way for modern diabetes care.

Landmark Advances Leading to Insulin

The quest for an effective diabetes treatment led to the iconic partnership between Frederick Banting, a surgeon, and Charles Best, a medical student.

Together with biochemist James Collip and physiologist John Macleod at the University of Toronto, they developed the pancreatic extract that would later be called insulin.

Their work began in the summer of 1921, and by January 1922, the first diabetic patient, Leonard Thompson, received an injection of insulin, effectively lowering his dangerously high blood glucose levels.

The Impact of Insulin on Diabetes Management

Before insulin therapy, patients with diabetes often succumbed to complications like kidney damage, cardiovascular disease, and a significantly reduced life expectancy.

The introduction of animal-derived pancreatic extracts revolutionized diabetes management by restoring the ability to regulate glucose levels in the body, thereby preventing acute episodes of hyperglycemia and hypoglycemia.

Insulin therapy quickly became a cornerstone of diabetes care, enabling patients to lead longer and more active lives.

Advancements in Insulin Delivery and Regulation

Over the following decades, advancements in insulin delivery and regulation significantly improved the lives of diabetic patients.

Companies like Eli Lilly and Company began mass-producing animal insulin under the brand name Iletin, making insulin widely accessible.

The development of synthetic insulins using recombinant DNA technology and the introduction of human insulin by Genentech in 1982 allowed for more predictable treatment outcomes.

Sequences like those of insulin glargine and other long-acting insulin analogs have since been designed to better mimic the body’s natural insulin release, reducing the risk of hypoglycemia.

Technology advanced further with the creation of insulin pens, insulin pumps, and continuous glucose monitoring systems, providing patients and healthcare providers with advanced tools for precise insulin delivery and diabetes management.