Troubled origins and lasting impact of the first insulin injection

In January 1922, a duty physician at Toronto General Hospital penned a note documenting the first injection into a human of pancreatic extract containing insulin. This event is widely seen as a turning point in medical history, converting the diagnosis of diabetes from a fatal illness into a treatable condition. Within a year, two of the key researchers, Frederick Banting and John MacLeod, were awarded the Nobel Prize. However, the research programme faced early operational and organisational difficulties, with the research team experiencing interpersonal tensions and competitive pressures. Subsequently, the first injection failed, and the team was salvaged only by biochemist James Collip, who prepared a more purified extract. A second successful injection was administered to 14-year-old Leonard Thompson 10 days later. The paper notes that the crude nature of the early preparation and its subsequent side effects would not meet modern regulatory frameworks. The initial method of delivery—a basic needle and syringe—remained unchanged for decades. The author suggests that current research methodologies and ethical standards would not allow this discovery story to unfold in the same way today. This paper argues that the appropriate widespread acclaim for the ‘discovery of insulin’ overlooks significant challenges, and while death was averted, suggests it was a ‘false dawn’ for many, changing diabetes into a chronic health issue with a challenging therapy and long-term complications.