VIEW: Inspired by insulin — Saleem H Ali
Diabetics worldwide can now live relatively functional lives and contribute to human achievement, exemplified by sportsmen such as Wasim Akram, or Oscar-winning Hollywood stars such as Halle Barre. Last month, William Cross, became the first Type-1 diabetic to summit Mount Everest — perhaps the ultimate test of human physical accomplishment. Such inspirational stories give us hope
At the tender age of five our son, Shahmir, was diagnosed with Type-1 diabetes. His symptoms of excessive thirst during the winter months had mentally prepared me for the worst news to come from the doctor. My wife and I were caught in a torrent of emotional turmoil as we were told how Shahmir’s life was to be dependent on a delicate balance of one indispensable molecule — insulin. This essential chemical, which is naturally secreted by the pancreas, was no longer being produced in Shahmir’s body. His immune system had mysteriously turned against his pancreas and misfired its defences to destroy the beta cells that produce insulin. The very system that nature had endowed to protect him from illness had caused his affliction. Our most abundant source of energy, carbohydrates, need insulin to be metabolised, otherwise our bodies quite literally become “sickly sweet” with glucose. Excessive amounts of sugars in the blood can act as a seductive poison that damages our nerves, kidneys and cardiovascular system. Just as we need a balance of carbohydrates to survive, we also need a balance of insulin. The most daunting challenge for us in keeping Shahmir healthy was to ensure that he got enough insulin but not too much. If he got even a few more units of insulin than his body needed, he could sink into hypolglycemic shock and risk sudden death.
Our sentiments swayed from denial, to anger to guilt to grief and finally acceptance of our predicament. The doctors assured us that there was nothing we could have done to prevent this illness since the complex confluence of genetic and environmental factors that cause Type-1 diabetes are very different from those that lead to the far more common and diet-related Type-2 diabetes. Shahmir was not obese or consuming excessive sweets, or displaying any unhealthy behaviour patterns, yet he would now have to lead a life of tremendous discipline and self-denial in order to survive. After the initial months of grief had abated, we reconfigured our lives and returned to a tenuous sense of normalcy.
As an academic, my coping strategy for this situation was to find out as much as I could about diabetes and most importantly about insulin. The Nobel Prize-winning discovery of this molecule in 1922 by Canadian researchers Frederick Banting, Charles Best and John Macleod is ranked among the most important medical achievements of all times. Millions of lives have been saved by the persistence of these men and their colleagues in numerous countries who struggled against all odds to extract the molecule. They were willing to persevere, even though many researchers before them had given up. Their allegiance to scientific methods as well as their willingness to collaborate with industry made it possible to mass produce insulin within a year of its discovery. The pharmaceutical company, Eli Lilly started producing bovine insulin through collaboration with the research team and a global effort was undertaken to distribute the life-saving medication. Long before the era of email networks or international organisations such as the United Nations, professionals from various fields united to work on an effective standardisation of insulin and make it available globally at an affordable cost. In the words of medical historian Christiane Sinding, the standardisation and distribution of insulin was “a result of the impressive working of a trans-disciplinary and trans-national network”.
It is through such efforts of uniting in our common humanity that diabetics worldwide can now live relatively functional lives and contribute to human achievement, exemplified by sportsmen such as Wasim Akram, or Oscar-winning Hollywood stars such as Halle Barre. Last month, William Cross, became the first Type-1 diabetic to summit Mount Everest — perhaps the ultimate test of human physical accomplishment. Such inspirational stories give us hope that Shahmir will also have a fulfilled life. Almost three years have passed since his diagnosis and he is doing very well in school and continues to enjoy most of the pleasures of childhood. His regimen of insulin injections has recently been transitioned to a digital device that infuses the precious molecule into his body when needed. We still have to check his blood sugar several times a day but he now considers these to be more metaphoric “pin pricks” of life. We are of course blessed to have the resources to provide for his needs. Global efforts to make life-saving medicines available to all those who need them must certainly continue. Science and human resilience have triumphed so far. Everyday we are reminded by his smile that the gift of life must never be taken for granted.
Dr Saleem H Ali is associate professor of environmental planning and conflict resolution at the University of Vermont and can be reached at email@example.com