The first dose failed
Insulin stopped children dying in weeks. The counter is the slow damage that living long enough made room for.
This counter is diabetes together with chronic kidney disease, rounded to 3 million deaths a year. They are paired because they travel together. Diabetes damages the vessels and the kidneys. High blood pressure damages the kidneys too, and a damaged kidney pushes the blood pressure up. A death in this slot has often had a heart attack waiting on the next card, and the certificate can only pick one. The story people tell about diabetes is a different illness from the one that fills the slot.
Toronto, Canada, January 1922
In December 1921, Leonard Thompson was admitted to Toronto General Hospital, in Canada. He was thirteen, born in July 1908. He weighed 65 pounds. Children with this form of diabetes, the form in which the body stops making insulin, died in weeks or months. There was a diet of a few hundred calories a day, and then there was coma.
On 11 January 1922, he was injected with an extract of animal pancreas made by Frederick Banting and Charles Best. It was impure. An abscess formed at the site. His blood sugar dipped, and he did not get better. The doctors stopped. James Collip, a biochemist brought in to clean the extract up, produced a purer batch. On 23 January, Thompson received that. His blood sugar fell to normal within a day. He improved.
He lived thirteen years on insulin. He died on 20 April 1935 of pneumonia and the complications of his diabetes. The university's own caption on his portrait says he was 27. He was born in July 1908, so he was 26. The portrait caption has the birthday wrong, or the age wrong. The dates are the part to keep.
The prize, and the other diabetes
The 1923 Nobel Prize went to Banting and J. J. R. Macleod, the professor whose laboratory it was. Best and Collip were left off the prize. Banting split his half of the money with Best. Macleod split his with Collip. The patents were sold to the University of Toronto for a dollar each. That part of the story is as good as its reputation. It is about a treatment for a particular diabetes, the one Thompson had.
It is the other diabetes that fills the counter. Insulin turned a disease that killed children quickly into a disease people live with for decades. Living with it long enough is how the other damage arrives: the heart, the vessels, the kidneys. Most of the diabetes deaths in the global figures are that slower disease, bound up with weight, diet and age, not a missing childhood hormone. Chronic kidney disease sits in the same 3 million whether diabetes caused it or blood pressure did. Thompson's abscess, and the dose that worked twelve days later, stopped one way of dying. The ticker is the way of dying that remained. What actually kills people uses a single patient, with diabetes, kidney disease and a heart attack, to show why the certificate still has to choose.
This is not health advice. It is a story about a population statistic. It says nothing about any one person's risk. If you have concerns about your health, speak to a doctor.
Sources
- Leonard Thompson's hospital record, University of Toronto.
- NobelPrize.org on the 1923 prize, and on Banting and Macleod sharing the money with Best and Collip.
- The Canadian Encyclopedia on the same split.
- The annual figure used on the counter is the Ledger's own rounding, set out on the methodology page.