History
In 1889 Oskar Minkowski and Joseph von Mering in Germany noticed that dogs whose pancreas had been removed developed diabetes, revealing the organ's role in blood sugar. In 1921 surgeon Frederick Banting and medical student Charles Best, working in John Macleod's lab at the University of Toronto, lowered diabetic dogs' blood sugar with pancreatic extract, and biochemist James Collip purified it. In January 1922 a 14-year-old boy, Leonard Thompson, became the first person treated and survived; Banting and Macleod won the 1923 Nobel Prize. The discoverers sold the patent to the university for $1 each, saying insulin belonged to the world.
How it works
After a meal, rising blood sugar prompts beta cells to release insulin, which opens muscle and fat cells to glucose and tells the liver to store the excess as glycogen. Glucagon and cortisol push blood sugar the other way. In 1955 Frederick Sanger worked out insulin's amino-acid sequence, the first for any protein, winning a Nobel Prize; in 1978 Genentech made human insulin in E. coli, and in 1982 it became the first approved recombinant drug.
Insulin resistance and treatment
In type 1 diabetes the immune system destroys beta cells, so insulin injections are essential. Type 2 begins with insulin resistance, when cells respond sluggishly because of excess weight and inactivity; lifestyle changes at the prediabetes stage can slow it down. Injected insulins are grouped by how fast and long they act, from rapid-acting to long-acting, and too high a dose or a skipped meal can cause hypoglycemia. Doctors track control with HbA1c.
This article is general health information and is not a substitute for diagnosis or treatment. If symptoms persist, see a doctor.
FAQ
- Once you start insulin, is it for life?
- In type 1, yes. In type 2, some people can cut back or switch to pills once blood sugar is stable, a decision made with a doctor.
- How can insulin resistance be improved?
- Weight loss, strength and aerobic exercise, fewer refined carbs and enough sleep are all known to help.
Sources reviewed: 2026-10-26
References
- Banting, F. G., Best, C. H., Collip, J. B., Campbell, W. R., & Fletcher, A. A. (1922). Pancreatic extracts in the treatment of diabetes mellitus. Canadian Medical Association Journal, 12(3), 141–146.
- Bliss, M. (1982). The Discovery of Insulin. University of Chicago Press.
- American Diabetes Association. (2024). Standards of Care in Diabetes—2024. Diabetes Care, 47(Suppl. 1).