24 Jan 2012 Diabetes: 90 years on from first insulin treatment

Ninety years after the breakthrough first use of insulin to treat diabetes, commemorated on Monday 23 January 2012, the disease remains one of the Western and developing worlds’ most challenging pandemic health issues. According to the World Diabetes Foundation (WDF), in 2010, 285 million people were living with diabetes – approximately 4,6% of the world’s population. The WDF anticipates that these figures will increase to 438 million (7,8%) by 2030…

Barbara Young, the chief executive of Diabetes UK, wrote this article for The Guardian newspaper:

Imagine a medical condition with no known cause that mostly affects children and young adults. The only treatment is a starvation diet, but the disease will eventually kill everyone it touches, often within weeks or months of diagnosis.

This was the situation for people diagnosed with type 1 diabetes in the early part of the 20th century. Today we celebrate the 90th anniversary of the scientific breakthrough that changed all that: on this day in 1922, insulin was first used to treat a patient with type 1 diabetes. This medical landmark has helped lift the death sentence that type 1 diabetes used to mean. Most people with the condition now live long and healthy lives.

On this anniversary, we at Diabetes UK will be remembering Frederick Banting, the great Canadian scientist responsible for this breakthrough. His work has saved countless lives across the world and today there are half a million people in the UK alone who would not be here were it not for insulin treatments.

But while it is right that we celebrate Banting’s work, when I hear people talking about the advancement in our understanding of diabetes it can often sound as though they are talking about a problem that has now been solved.

Sadly, this is not the case.

It is true that we have come a long way since the first injection of insulin in 1922 and the lot of someone with type 1 diabetes today is immeasurably better than it would have been 90 years ago. Much of this is because of research and campaigning by Diabetes UK.

However, this success can sometimes obscure the fact that we still have a long way to go to give the 3.7m people with diabetes in the UK – both type 1 and type 2 – the healthcare and information they need to manage their condition and to raise awareness among the further 7m people who are at high risk of developing type 2.

Diabetes remains the leading cause of blindness in people of working age and is the cause of thousands of amputations a year. About 10% of the NHS budget is spent on diabetes and 850,000 people have type 2 diabetes but do not know it.

But perhaps the starkest statistic is that while most people with diabetes do have long and healthy lives, type 1 diabetes reduces life expectancy by an average of 20 years, while type 2 reduces it by an average of 10 years. This does not sound to me like a problem that has been solved.

So yes, let’s use today’s anniversary to remember the remarkable work of Banting and to celebrate the positive impact scientific research can have on people’s lives.

But let’s also use it to raise awareness of the fact that diabetes remains one of the biggest health challenges we face today, and to express outrage that every week there are 70 diabetes-related amputations that could have been prevented through earlier diagnosis and better management of the condition.

Perhaps the most frustrating thing is that this is happening despite there being broad agreement about what effective risk assessment and diagnosis, care and support look like – our 15 healthcare essentials that we are promoting to everyone with diabetes, their healthcare providers and those who make decisions about healthcare.

After all, anniversaries are about looking to the future as well as remembering the past. And just as the challenge for Banting and his colleagues was to keep people with type 1 diabetes alive, our challenge today is to bring an end to the scandal of preventable complications and early death in these patients.

Doing this does not mean spending lots of extra money. It simply needs more political will and better, joined-up working in preventative and care services. This is the only way we can make sure it doesn’t take a further 90 years before we can celebrate another radical improvement in the lives of people with diabetes.

The situation in South Africa:

There is an explosion of diabetes worldwide and developing countries like South Africa are the worst hit. The World Health Organisation (WHO) predicts that in South Africa, the numbers will triple in the next 15 years.

Although all groups are affected, those most at risk are the black community who are undergoing rapid lifestyle and cultural changes, and people of Indian descent who have a gene pool that makes them unusually susceptible to diabetes.

Research shows that approximately 4-6 million people in SA have diabetes and that most of these people are unaware that they have the condition.

Around the world it has been shown that patient education and motivation reduces the cost of diabetes care as well as reducing the risk of serious diabetes-related complications, dramatically.

In order to manage diabetes, one needs to be educated in all facets of the condition, with special emphasis on diet, medication and exercise.

Currently in South Africa, the lower income population suffering with diabetes and its complications receive no education or assistance from Government.

Source: Diabetes South Africa; www.diabetessa.co.za