Page 413 - Handbook of Biomechatronics

408 Graham Brooker

During the second half of the 19th century a number of important dis-
coveries relating to diabetes occurred. These included observations by Paul
Langerhans of two different cell types in the pancreas of which one produced
normal pancreatic fluid but the function of the other was unknown. These
cells were later discovered to produce insulin and named the “Islets of
Langerhans” in his honor. A few years later, two researchers from the Uni-
versity of Strasbourg, Joseph von Mering and Oskar Minkowski, removed
the pancreas from a dog to identify its effect on digestion, but instead dis-
covered that the dog developed diabetes. A year later Minkowski adminis-
tered dried pancreas and later injected pancreatic extracts subcutaneously
without obtaining an effective response from the dogs (Leiva-Hidalgo
et al., 2011).
During the first two decades of the 20th century, the relation between
diet and diabetes was thoroughly investigated. A number of researchers
including Rennie and Frazer from the Aberdeen Royal Infirmary and Georg
Zuelzer in Berlin investigated the effects of both oral and injected pancreatic
extracts with Zuelzer having some success in his treatment of patients. How-
ever, during these trials many animals and some people suffered from serious
side effects including fever, convulsions, as well as shivering and sweating
caused by hypoglycemic shock. Consequently, human tests were discon-
tinued for a time. Further research conducted by Israel Kleiner and Nicolae
Paulescu confirmed the effects of pancreatic extracts on the glucose levels in
dogs that had had their pancreases surgically removed. Paulsecu’s research
describing the isolation of “pancreatine” was only published in 1920 at about
the same time that Frederick Banting apparently conceived of the idea of
insulin after reading Moses Barron’s paper relating the Islets of Langerhans
to diabetes. He and a number of other researchers also experimented with
different pancreatic extracts on the health of de-pancreatized dogs. Banting
and John Macleod were awarded the 1922 Nobel Prize for Physiology and
Medicine for creating usable insulin. Paulescu wrote to the Nobel Prize
committee claiming that he had discovered and used insulin first, but his
claims were rejected.
Banting and Macleod were not successful in producing useful pancreatic
extracts for their experiments until they were joined by James Collip who
developed a successful process for extracting insulin using a double precip-
itation process in ethanol. His extract was tested on a 14-year-old child and
appeared to be successful over the following months. This and successful
tests on more diabetic patients lead to Eli Lilly and the University of Toronto
collaborating on the production of large quantities of insulin for the