Diem Peter
Endokrinologie Diabetologie Bern.
Ther Umsch. 2020 Sep;77(7):289-296. doi: 10.1024/0040-5930/a001194.
The Discovery of Insulin The initiative for the work that led to the discovery of insulin in Toronto in 1921 came from Frederik G. Banting. He worked under the direction of John J. R. Macleod in the Institute of Physiology at the University of Toronto. In his experimental program he was assisted by the student Charles H. Best. On dogs with experimental diabetes they demonstrated the blood sugar-lowering effect of pancreatic extracts. Thanks to collaboration with Macleod and James B. Collip, a biochemist from the University of Alberta who was on sabbatical in Toronto, the work was quickly crowned with success and the first clinical applications of the extracts became possible in early 1922. As early as 1923, Banting and Macleod were awarded the Nobel Prize for Physiology or Medicine. Banting shared his half of the prize with Best, while Macleod shared his half with Collip. That their research was crowned with success is probably due in large part to Banting's abilities as a surgeon, Best's enthusiasm as a student, Collip's abilities as a biochemist and Macleod's prudence in bringing the group together and providing it with the necessary resources. In the 1950s, important advances were made in insulin research that were to spur further research in diabetology. These included the clarification of insulin structure and the possibility of measuring insulin in the blood. These two discoveries were awarded the Nobel Prize for Chemistry (see Kasten 1). In the 1960s-70s, insulin manufacturers developed ever better purification methods, which eventually led to preparations with very good tolerability and only very rare allergies. Later, in the 1980s, the possibility of biotechnological production of insulin led to an ever-increasing spread of human insulin. Based on the same technology, insulin analogues were produced in the 1990s and then in the new millennium, which, as "designer insulins" so to speak, enabled new clinically interesting active profiles. Today's variety of available insulins, modern forms of insulin application (insulin pens, insulin pumps) and blood glucose self-monitoring or continuous glucose monitoring form the basis of modern intensive insulin therapy.
胰岛素的发现 1921年在多伦多导致胰岛素发现的这项工作的倡议来自弗雷德里克·G·班廷。他在多伦多大学的生理研究所约翰·J·R·麦克劳德的指导下工作。在他的实验项目中，学生查尔斯·H·贝斯特协助他。在患有实验性糖尿病的狗身上，他们证明了胰腺提取物的降血糖作用。由于与麦克劳德以及来自阿尔伯塔大学正在多伦多休假的生物化学家詹姆斯·B·科利普合作，这项工作很快取得成功，提取物的首次临床应用在1922年初成为可能。早在1923年，班廷和麦克劳德就被授予诺贝尔生理学或医学奖。班廷将他的一半奖金与贝斯特分享，而麦克劳德则将他的一半与科利普分享。他们的研究取得成功很大程度上可能归功于班廷作为外科医生的能力、贝斯特作为学生的热情、科利普作为生物化学家的能力以及麦克劳德将团队聚集在一起并为其提供必要资源的谨慎态度。在20世纪50年代，胰岛素研究取得了重要进展，这推动了糖尿病学的进一步研究。这些进展包括胰岛素结构的阐明以及在血液中测量胰岛素的可能性。这两项发现被授予诺贝尔化学奖（见卡斯滕1）。在20世纪60年代至70年代，胰岛素制造商开发出越来越好的纯化方法，最终导致制剂具有非常好的耐受性且过敏情况极为罕见。后来，在20世纪80年代，生物技术生产胰岛素的可能性导致人胰岛素的使用日益广泛。基于相同技术，胰岛素类似物在20世纪90年代以及新千年被生产出来，可以说作为“定制胰岛素”，具有新的临床上有趣的活性特征。如今各种可用的胰岛素、现代胰岛素应用形式（胰岛素笔、胰岛素泵）以及血糖自我监测或持续血糖监测构成了现代强化胰岛素治疗的基础。
