healthyD.com (17/08/21)(in Chinese)

100 Years of Insulin | Diabetes was once an incurable disease! Internal Medicine Specialists Explain the Function of Insulin and Treatment of Diabetes

View original article: Experts Decode | 100 Years of Insulin | Diabetes was once an incurable disease! Internal medicine specialists explain the function of insulin and the treatment of diabetes

Humans knew about diabetes 2,500 years ago, but before the invention of insulin, having diabetes was like being sentenced to death, because this fatal disease was not only incurable, but patients lacked insulin and might only have three months to two years left to live after diagnosis. It was not until the early 20th century that experts prescribed a low-calorie diet for diabetics, which prolonged the patients’ lives but made them very weak and had to endure hunger, eventually dying from diabetic ketoacidosis or malnutrition.

The development of insulin?

Insulin has been used to treat diabetes since the early 20th century. The original method of obtaining insulin was to extract it from the pancreas of animals. Scientists have since worked hard to use gene recombination to produce second-generation short- and medium-acting insulins that are exactly the same as human insulin sequences, but patients need to wait 30 minutes after injection before eating, and there is a higher chance of nocturnal hypoglycemia. In the late 1990s, scientific research and clinical medical staff developed insulin analogs that can well simulate the physiological insulin secretion pattern, also known as fast-acting insulin and long-acting basal insulin. Patients no longer need to wait 30 minutes before eating, and the risk of nocturnal hypoglycemia is reduced.

Traditionally, insulin injection is still the most common and effective method for treating diabetes. However, injecting insulin once a day or even multiple times a day obviously brings a lot of inconvenience to patients. As a result, some new insulin treatment methods have emerged, such as pulmonary inhalation preparations, oral preparations and subcutaneous implant preparations.

Insulin injection tools

Long, long ago, the only way to inject insulin was to use a syringe, and patients had to draw the medicine and inject it themselves. Thirty or forty years ago, a pharmaceutical company invented an insulin injection pen, which replaced the tip of a fountain pen with a needle and the ink in the pen cartridge with insulin. The needles used by children are generally short and thin (30-32G), so the patient feels less pain during the injection.

Of course, the insulin pump, also known as a continuous subcutaneous insulin infusion therapy device, is indispensable. In a sense, it can be called an “artificial pancreas”. The insulin pump is filled with insulin, and insulin is continuously and accurately infused into the body 24 hours a day through a thin and soft tube. It simulates the working mode of a normal pancreas in the human body, and continuously infuses a small amount of insulin (called the basal rate) on a regular basis, simulating our insulin secretion when we are not eating, and maintaining blood sugar stability when we are not eating. A certain dose of insulin is infused before a meal to ensure that the food eaten will not cause a large fluctuation in blood sugar.

The development of insulin has a history of a century. After generations of efforts, there have been major leaps in terms of sugar control effect, safety and ease of use. Diabetes is a very “sweet” disease, but it brings a lifetime of pain. With the continuous innovation of medical technology, it is hoped that in the near future, scientists will find a way to cure diabetes, and insulin will gradually fade out of doctors’ prescriptions, and patients will not have to receive injection treatment for life.

Data provided by: Children’s Diabetes Association, Princess Margaret Hospital, Yan Chai Hospital Pediatric Endocrinology Specialist Dr. Antony Fu