On 23 January 1922, Canadian teenager Leonard Thompson, nearing the hitherto inevitable death from early onset diabetes, was given the first dose of purified ‘Toronto insulin’. His condition and test results improved rapidly and dramatically, signalling the research team’s success.
Twelve days earlier, Leonard’s injection of a pancreas extract, prepared by team members, Dr Frederick Banting and graduate student Charles Best, had been unsuccessful. However, the fourth member on the team, biochemistry Professor JB (Bert) Collip had rapidly improved the purity of the Toronto extract by using increasing concentrations of alcohol to eliminate contaminants, as recommended by Macleod. After preliminary tests of potency and safety on rabbits, Collip’s extract was ready for its spectacular debut.
Frederick Banting and John Macleod, the only members of the Toronto team nominated, shared the 1923 Nobel Prize for Medicine or Physiology. Banting shared his prize money with Best and Macleod shared his with Collip.
John Otto, founder and Chairman of the JJR Macleod Memorial Statue Society in Aberdeen – himself diagnosed with type 1 diabetes just before his 9th birthday almost 50 years ago – says an important aim of World Insulin Day is to set the record straight about Professor Macleod's vital role in the discovery:
“Back in the late 1980s, I was attending a routine appointment at Woolmanhill Diabetes Clinic in Aberdeen and noticed on the wall a picture of John James Rickard Macleod with a caption saying he was a co-discoverer of insulin. Then I read that he lived here, was educated in Aberdeen and is buried in local Allenvale Cemetery.
“I think, prior to the 1980s, nobody in Aberdeen knew about JJR Macleod – even the senior diabetologist here. The history books had always wrongly credited the discovery of insulin only to Banting and Best.
“It wasn't until Michael Bliss, a historian at Toronto University had his book ‘The Discovery of Insulin’ published in 1982 – a book that some in authority asked him not to write – that five decades of Macleod being effectively airbrushed from history began to be reversed. Bliss’s myth-busting book told the true story behind the discovery of insulin, revealing that this tremendously well organised and solid scientific achievement would not have been realised but for Macleod.
“Yes, Banting and Best were involved – obviously they were – but, without Professor Macleod's extensive knowledge, research expertise and guiding wisdom, it can be said categorically that insulin would not have been discovered in Toronto in 1922.
“After reading about Professor Macleod I went to Allenvale Cemetery and stood by his grave vowing that one day I would try and do something to recognise his wonderful legacy – that a man from Aberdeen was responsible for saving over 200 million lives.”
John Otto says the advances in treatment for people with type 1 diabetes in his lifetime have been phenomenal. He remembers his father boiling glass and stainless steel syringes for sterilisation, that they would reuse the needle until it became blunt, and that everything was about managing your diet and stringent meal times. Adjustable dose pens with single-use micro-fine needles became available in the late 80s, a milestone in insulin delivery. Intelligent insulin pumps surfaced in the 2000s and now the artificial pancreas is becoming a reality, alongside hopes that stem cell reprogramming or genetic engineering may yet provide a cure.
John Otto admits that Professor Macleod's own modesty played a part in his lack of recognition compared with his team members:
"There was a lot of infighting for recognition amongst the team. But Jack Macleod, as his friends knew him, wasn't interested and said to them, ‘you can take the credit for this’.
"In the years following the 1922 discovery, his reputation was being tarnished by others who sought to promote their own contributions to an inaccurate version of events, so he left Canada and returned home to Aberdeen. This was not before being instrumental in ensuring successful commercial production of insulin and availability in the US, Europe and elsewhere.
“JJR Macleod was appointed Regius Professor of Physiology at Aberdeen University in 1928 and seems to have avoided talking about his role in the Toronto breakthrough from then until his death in 1935.”
Later this year, a memorial to JJR Macleod will be unveiled in Aberdeen’s Duthie Park to mark the centenary of his Nobel Prize award as work to build national and global recognition of his achievement continues.
“His memorial will be a life-size statue sitting on a park bench and cast entirely in bronze, displayed on a mosaic of local granite,” says John Otto.
“He will be gazing out across the park towards the bandstand watching families and children playing – which seems appropriate as type 1 diabetes is primarily a condition affecting younger people – including some who might not have survived to play in the park had it not been for insulin's gift of life.”