Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, USA.
The Center for Diabetes & Metabolic Diseases, Indiana University School of Medicine, Indianapolis, IN, USA.
Nat Med. 2021 Jul;27(7):1154-1164. doi: 10.1038/s41591-021-01418-2. Epub 2021 Jul 15.
The year 2021 marks the centennial of Banting and Best's landmark description of the discovery of insulin. This discovery and insulin's rapid clinical deployment effectively transformed type 1 diabetes from a fatal diagnosis into a medically manageable chronic condition. In this Review, we describe key accomplishments leading to and building on this momentous occasion in medical history, including advancements in our understanding of the role of insulin in diabetes pathophysiology, the molecular characterization of insulin and the clinical use of insulin. Achievements are also viewed through the lens of patients impacted by insulin therapy and the evolution of insulin pharmacokinetics and delivery over the past 100 years. Finally, we reflect on the future of insulin therapy and diabetes treatment, as well as challenges to be addressed moving forward, so that the full potential of this transformative discovery may be realized.
2021 年是班廷和贝斯特划时代地描述胰岛素发现一百周年。这一发现和胰岛素的迅速临床应用，将 1 型糖尿病从致命的诊断转变为可通过医学手段控制的慢性疾病。在这篇综述中，我们描述了促成这一医学史上重要时刻的关键成就，包括对胰岛素在糖尿病病理生理学中的作用的理解、胰岛素的分子特征以及胰岛素的临床应用方面的进展。我们还从接受胰岛素治疗的患者的角度以及过去 100 年来胰岛素药代动力学和给药方式的演变来看待这些成就。最后，我们反思了胰岛素治疗和糖尿病治疗的未来，以及未来需要解决的挑战，以便充分发挥这一变革性发现的潜力。
