Slide 2:"So to begin, let's talk first about Diabetes. Does anyone have or know someone who has Diabetes? What do you know about Diabetes?"Slide 3:Diabetes is a metabolic disease.
In a healthy body, glucose is controlled by naturally produced insulin, adjusting as necessary to the consumption of or absence of food. Diabetes is caused by the lack of insulin production, insufficient insulin production, or the body's inability to use insulin effectively causing a condition known as hyperglycemia.
"Who knows what Insulin is?"Insulin is a hormone which is produced by the pancreas.
Slide 4: Type One diabetes, explain diagramType 1 is an autoimmune disease in which the body makes little or no insulin. What happens is that the immune system begins to attack the cells in the pancreas that create insulin for an unknown reason. There is no known cause and no way to prevent it. It is not caused by consuming too much sugar.
Type 1 develops most often in children and young adults before age 30, although it can appear at any age.
A person who has type 1 diabetes must take insulin daily to live. Lifestyle changes such as healthy eating and increased physical activity are basic therapies. Blood glucose levels must be closely monitored through frequent blood glucose testing.
Complications: Early heart disease, amputation, stroke, kidney failure, nerve damage, blindness.
Slide 5: Type Two Diabetes, explain diagramType 2 Diabetes is the most commonly diagnosed type. In this case, the body can't use the insulin it makes.
Associated with those age 40 or older, however type 2 is increasingly being diagnosed in children and adolescents. Risk factors include obesity, family history of diabetes, high blood pressure, abnormal cholesterol levels, and physical inactivity.
Healthy eating, physical activity and blood glucose testing are basic therapies. Many require oral medication, insulin or both to control blood glucose levels.
Complications: High blood glucose levels over a long period can cause blindness, heart disease, kidney problems, amputations, nerve damage and erectile dysfunction.
Slide 6: Common SymptomsThe most prominent symptom of the onset of diabetes is a very high level of thirst accompanied by a very high level of urine output. An increase in appetite is normal but despite this, before a person has been diagnosed they'll also lose a lot of weight. Fatigue, nausea, vomiting, blurry vision, skin infections, bladder infections and coma are all relative symptoms of undiagnosed or untreated diabetes.
Slide 7: Risk FactorsRisk factors for diabetes include dietary issues, such as diets high in sugars, carbohydrates and fats, although dietary issues need to be excessively high in most cases. Family history often means that someone may be genetically predisposed to developing diabetes. Obesity can often be a risk factor for type 2 diabetes.
Slide 8: Diabetes in HistoryAccording to the Canadian Diabetes Association, the earliest recorded documentation of diabetes was in 1552 BC on Egyptian papyrus, by a physician who took notice of the symptom of frequent urination. Found descriptions of "the disease of too much urine" (Untreated diabetes causes people to urinate almost constantly.)Arabic, Chinese, Indian, and other early cultures also left writings describing it.
In the first century A.D. a Greek physician named the condition "diabetes" meaning "to pass through," because the disease made urine pass through the body.
Slide 9: Diabetes in History Cont'd, Paul Langerhans, explain diagramIn the late 1800s a German student, Paul Langerhans, looked at a pancreas through a microscope. (The pancreas is a jelly-like organ behind the stomach.)He saw cells that formed little islands--now called the islets of Langerhans. What did those little islands produce? Paul thought it was a special kind of chemical. (We now call it a hormone.) What did the hormone do? No one knew.
Slide 10: Diabetes in History Cont'd, Joseph/OskarAbout 20 years later, two scientists-- In 1889 the German physicians Joseph von Mering and Oskar Minkowski had shown that removal of the pancreas in dogs produced the disease. They proved that the pancreas keeps people from having diabetes.
What could the pancreas have that was powerful enough to prevent diabetes? Perhaps, some researchers thought, it was that hormone in the islets of Langerhans!The only way to prove it was to give it to someone with diabetes and this is where Banting comes in…Slide 11: Banting's LifeFrederick Grant Banting was born on Nov. 14, 1891 in Alliston, Ont. He was the youngest of five children. Following high school, he briefly Divinity College at the University of Toronto before dropping out and enrolling in medical school.
The day after his graduation from medical school in 1916 Banting enlisted in the Royal Canadian Army medical corps. He was sent to the front lines where he flourished as a surgeon and on Sept. 28 1918, Banting crossed intense shellfire to attend to a battalion of wounded Canadian soldiers. While tending to the soldiers injuries, he was struck by a piece of shrapnel in his right arm. He was later awarded the Military Cross for bravery.
In 1919, Banting returned to Canada and on Oct. 31, 1920 he read a journal article about diabetes research which sparked a moment of inspiration. The 28-year-old quickly recorded his thoughts in a notebook -Slide 12: Basic Idea, explain diagram"Diabetus Ligate pancreatic ducts of dogs. Keep dogs alive till acini degenerate leaving Islets. Try to isolate the internal secretion of these to relieve glycosurea."to try and extract the mysterious hormone associated with the withering disease from the pancreases of dogs.
Slide 13: The Process, Picture of BestWith this in mind, Banting spent several months looking for lab space, finally finding a sympathetic ear in John James Richard Macleod, a University of Toronto professor and diabetes expert. In May 1921, Macleod introduced Banting to 22-year-old Charles Best, one of his brightest students who had moved from the U.S. to study medicine.
Charles Best was born on Feb. 17, 1899 and grew up in New Brunswick. Best would accompany his father, a country doctor, as he made his rounds and administered ether to his patients. Best also served in the Canadian Army, acting as a sergeant with the Canadian tank corps. Upon his return home, he changed his major from arts to science at the University of Toronto.
Slide 14: The Process Cont'd, Picture of Collip and Leonard ThompsonOver the summer of 1921 they conducted numerous tests on dogs, advancing their ideas with guidance from the more experienced Macleod. Along the way, another researcher, James Bertram Collip, helped to refine a workable sample of insulin for human use.
On Jan. 23, 1922 the researchers gave their serum its first human trial on 14-year-old Leonard Thompson who weighed only 65 pounds. Nothing happened. Was insulin a failure? Fortunately, the doctors tried again. This time they used a purer dose, and Leonard's body responded, proving that insulin worked!With insulin reintroduced to their blood stream, diabetics could bring their blood sugar level under control for the first time. The discovery, though not a cure for the disease, heralded a new healthy life for millions living with diabetes.
Slide 15: Teddy Ryder, explain pictureTeddy Ryder was six years old and weighed only 26 pounds when his uncle, a doctor, asked Dr. Banting for insulin. But there was hardly any available. "Wait until September," Dr. Banting told him.
"He won't be alive in September," Teddy's uncle answered. Dr. Banting managed to find insulin for Teddy. And by the time "little" Teddy Ryder died at age 77, he had probably been on insulin longer than anyone else alive at the time.
Slide 16: Nobel PrizeBanting and Macleod were announced as the recipients of the Nobel Prize in Physiology or Medicine on Dec. 10, 1923.
Though it was a first for Canada, Banting and Macleod's Nobel win was a surprise to many in the medical world. Traditionally Nobel winners in the physiology or medicine were nominated at least twice before being awarded the prize. The Canadian pair's win came after their first ever nomination.
Slide 17: Patent, explain figuresIn a selfless move, the quartet decided not to seek a patent for their life-saving serum, a move that surely cost them a fortune. Instead, they sold the rights to their formulation to U of T for $1 as a means of ensuring that insulin could be affordably manufactured for years to come.
Slide 18: Banting's Life Cont'dIn addition to his Nobel Prize, Banting was bestowed a lifetime annuity of $7,500 by parliament in 1923, and in 1934, he was knighted.
For the rest of his life, Best would have his hotel bills anonymously paid by grateful diabetics.
Best went on to pursue graduate studies and became a professor of physiology at the University of Toronto.