Diabetes has been known since antiquity. We present here a historical perspective on the concepts and ideas regarding the physiopathology of the disease, on the progressive focus on the pancreas, in particular on the islets discovered by Langerhans in 1869, leading to the iconic experiment of Minkowski and von Mering in 1889 showing that pancreatectomy in a dog induced polyuria and diabetes mellitus. Subsequently, multiple investigators searched for the active substance of the pancreas and some managed to produce extracts that lowered blood glucose and decreased polyuria in pancreatectomized dogs but were too toxic to be administered to patients. The breakthrough came 100 years ago, when the team of Frederick Banting, Charles Best, and James Collip working in the Department of Physiology headed by John Macleod at the University of Toronto managed to obtain pancreatic extracts that could be used to treat patients and rescue them from the edge of death by starvation, the only treatment then available. This achievement was quickly recognized by the Nobel Prize in Physiology or Medicine to Banting and Macleod in 1923. At 32, Banting remains the youngest awardee of this prize. Here we discuss the work that led to the discovery and its main breakthroughs, the human characters involved in an increasingly dysfunctional relationship, the controversies that followed the Nobel Prize, and the debate as to who actually “discovered” insulin. We also discuss the early commercial development and progress in insulin crystallization in the decade or so following the Nobel Prize.

中文翻译：

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胰岛素：一个有着 100 年历史的发现，有着迷人的历史

糖尿病自古以来就为人所知。我们在此展示有关疾病生理病理学的概念和观点的历史视角，以及对胰腺的逐步关注，特别是朗格汉斯在 1869 年发现的胰岛，导致 Minkowski 和 von Mering 在 1889 年的标志性实验显示对一只狗进行胰腺切除术会引起多尿症和糖尿病。随后，多名研究人员搜索了胰腺的活性物质，一些研究人员设法生产出能够降低胰腺切除犬的血糖和多尿但毒性太大而无法用于患者的提取物。这一突破出现在 100 年前，当时 Frederick Banting、Charles Best 的团队，James Collip 在多伦多大学 John Macleod 领导的生理学系工作，设法获得了胰腺提取物，可用于治疗患者并将他们从饥饿的死亡边缘拯救出来，这是当时唯一可用的治疗方法。这一成就很快被 1923 年的诺贝尔生理学或医学奖授予班廷和麦克劳德。32 岁的班廷仍然是该奖项最年轻的获奖者。在这里，我们讨论了导致这一发现的工作及其主要突破，涉及日益失调的关系的人类角色，诺贝尔奖之后的争议，以及关于谁真正“发现”胰岛素的争论。我们还讨论了诺贝尔奖后十年左右胰岛素结晶的早期商业发展和进展。