Insulin--history, biochemistry, physiology and pharmacology.

The discovery of insulin was a seminal event in both the study of diabetes and the care of diabetic pa tients. The development of procedures for purifying and modifying insulin took an additional 30 years. In his masterful rendition of these developments, Mi chael Bliss recounts the remarkable story surrounding the discovery of insulin and notes that the discovery of insulin at the University of Toronto in 1921-22 was one of the most dramatic events in the history of the treatment of disease.1 Insulin received its name before it was discovered in 1889. In Germany, Oskar Minkowski and Joseph von Mering observed that total pancreatectomy in ex perimental animals leads to the development of severe diabetes mellitus and begun the speculation that a mysterious substance produced by the pancreas is responsible for metabolic control.1 By the first decade of the Twentieth Century it was widely hypothesized that an “internal solution” of the pancreas controls carbohydrate metabolism.1 Even so there was so much impressionistic evi dence supporting the existence of pancreatic internal secretion emanating from the islet cells that in 1907 a Belgian investigator J de Meyer proposed it be named “insulin”. In 1916, Sharpey Schafer in Britain inde pendently suggested the same name. Much truth is in the notion again clarifi ed by hindsight, that insulin was sitting there waiting to be isolated or “discov ered”. It almost certainly would have been found during the second decade of the 20th Century, but the work of Central European researchers, such as Zuelzer and the Romanian physiologist, NC Paulesco was ut terly disrupted by World War I.1