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Keywords:

  • discovery of insulin;
  • nobel prize 1923;
  • Frederick Banting;
  • J. J. R. Macleod;
  • James Collip;
  • Charles Best;
  • insulin;
  • Oskar Minkowski;
  • Nicolae Paulescu;
  • Moses Barron;
  • Michael Bliss;
  • Elliott Joslin; post-traumatic stress disorder;
  • Eli Lilly;
  • Connaught;
  • insulin mechanism of action

Summary

2012 marks the 90th year since the purification of insulin and the miraculous rescue from death of youngsters with type 1 diabetes. In this review, we highlight several previously unappreciated or unknown events surrounding the discovery. (i) We remind readers of the essential contributions of each of the four discoverers – Banting, Macleod, Collip, and Best. (ii) Banting and Best (each with his own inner circle) worked not only to accrue credit for himself but also to minimize credit to the other discoverers. (iii) Banting at the time of the insulin research was very likely suffering from post-traumatic stress disorder (PTSD) that originated during his heroic service as a surgeon in World War I on the Western Front in 1918, including an infected shrapnel wound that threatened amputation of his arm. His war record along with the newly discovered evidence of a suicide threat goes along with his paranoia, combativeness, alcohol excess, and depression, symptoms we associate with PTSD. (iv) Banting's eureka idea, ligation of the pancreatic duct to preserve the islets, while it energized the early research, was unnecessary and was bypassed early. (v) Post discovery, Macleod uncovered many features of insulin action that he summarized in his 1925 Nobel Lecture. Macleod closed by raising the question – what is the mechanism of insulin action in the body? – a challenge that attracted many talented investigators but remained unanswered until the latter third of the 20th century. Copyright © 2012 John Wiley & Sons, Ltd.