equal treatment from the critics and from the readers. it happens very rarely here. when it does happen, people are just confounded. they just can't believe it. .. a ph.d. in biochemistry, and she had worked for the cia. she was also the daughter of a safari traveler, so she had been all over the world, hunted wild

animals and so on. when science-fiction started to come out, who is this macho, heroic, wonderful writer? she or he, james one of the worst that you could. everybody was saying, oh, this is just the best there has ever been. all this speculation that this was somebody who clearly has been a spy, clearly is a scientist, clearly a military man, clearly a very adventurous man, and then eventually james was added as a woman. now, when that happened, that is a relief. i don't have to do that anymore. she kept writing. nobody wanted to read the work. it is melodramatic to say that she actually committed suicide, which she did. that think that there is a very

persistent attitude about, you know, what kind of work men produce and its signature is really what we are talking about, not creativity, imagination, skill, signature is this a man's or woman's name. that is why in europe still you go back, a lot of writers published under their initials. p. d. james. mystery writers particularly. women writers will publish under initials because there are gender neutral, and people don't necessarily know. by the time they discover it is too late to change their mind or to say that they change their mind. at think all of these things make a big difference. >> we have time for one more quick question. >> the last question. if most of the leaders are women

and i don't know whether if a poll was conducted, but if you were to conduct a poll and ask one and how your writers, men or women, like the think? >> i don't think it would be very conclusive. women are very well reading books by male writers. i will ask women in this room. most of you were like me. when you or the liberals, did you read books about boys? how many did? you didn't? you didn't? uh-oh, you didn't read the hardy boys' are huck finn or anything like that? and then if you ask the boys, the man, how many when you were the boys didn't read books about girls? not many. even the great american girls books of all time, though women, which is a book that every year somebody will do a palm and

asked the governors, probably even sarah palin has read it. what was your favorite children's book. all of the women will say little woman. never been cited by a man. well, then down regional men either. any man in this room that have read the man? no, wait. no, wait. it's feminizing and therefore stigmatizing for a man to read about male experience is expanding and probable keep out -- positive for a woman. positive. >> she wrote under a pseudonym for so many years. contraband, the one you have in here.

>> ab varner. >> exactly. >> and some of those are very racy. read by men he did not know. and there are some things in the book that were written, i put in some early things by women that are quite violent, not at all what you would expect 19th century woman. as an indication, it very interesting, but an indication that women could write anything but were expected to write in a certain way. and, you know, the school one, the contempt of male writers toward the female competitors, which is what they were well into the 20th century was just extraordinary. hawthorne to having line. absolute contempt. and that is because the women were selling better. the can never deflect. look for the money. he can neglect that.

there were many other factors as well. bank you so much all for coming. it's very nice of you to come out on the stormy night. i really appreciated very much. >> author elain showalter discussing her book ads and politics & prose bookstore. is there a nonfiction author you would like to see featured on book tv? de moss portrayed us. >> next, at arthur ainsberg presents his book "breakthrough." elizabeth hughes, the discovery of insulin, and the making of a medical miracle at the new york university school of medicine. this is about an hour.

[silence] [silence] >> multiple setbacks which fortunately culminated in insulin being purified and made available to diabetics have your the discovery of insulin by frederick banting, at charles best represents one of the greatest medical advances in history. the development took about two years. today in the drug takes 10-15 years to navigate, development, and regulatory the bill. the costs associated with developing the drug is also increasing dramatically.

a new drug often exceeds a billion dollars in costs. insulin costs $1,400 to discover. i have all the invoices. $250,000 to develop the product -- process for mass production and clinical review. for me this story is quite personal. in 1975 when i was 28 years old i was diagnosed with hodgkin's disease. until the early 1960's hodgkin's had been a death sentence. i was fortunate enough to be diagnosed at that time when the treatment was available, and i was cured. because of my own experience i felt a deep connection to the story. elizabeth hughes as the one who faced a dire diagnosis to her family stayed by her side and to the researchers whose tireless effort completely changed the odds of survival. the discovery of insulin

occurred almost 90 years ago. this medical miracle is just as important today as it was on the day it was discovered. in fact and there are today nearly 300 million people with diabetes worldwide. our story begins in 1919, the youngest daughter of the most famous politician in america has just been diagnosed with what was then the death sentence, juvenile diabetes. according to the mortality tables she would be dead in 11 months. elizabeth's story, the story of the man who kept her alive and of the four discoverer's is one of hope, courage, determination, and miracles. in order to better understand the magnitude of this amazing discovery it is important to know of a bit more about diabetes in its history. when you have diabetes your body at it does not make enough insulin or can't use the insulin it does produce as well as it should. the pancreas, and organ in the

stomach produces the hormone which helps glucose gets into the body cells. if your body is not producing insulin than you cannot manufacture metabolized glucose. if you are unable to metabolize glucose you cannot live. diabetes is a century old disease recorded as far back as 1550 bc. ancient egyptians. their preferred method of treatment included eating a boiled assortment of bones, we grain, and earth. while this may seem absurd, it is actually not that far off for the treatment of the early it 20th-century. for 25,000 years the more was learned about diabetes. in the 18th centuries scientists discovered that the sweet substance found in urine lusher. in the 19th century scientists isolated the islands, a cluster of cells in the pancreas that

secrete a hormone which lowers glucose levels in the blood, this mysterious pancreatic secrete and was named insulin. despite this knowledge physicians were helpless to prevent the death of those diagnosed. while waiting for a miracle cure doctors turned to a radical starvation treatment to prolong the lives of their patients. this radical treatment was developed by frederick, one of the leading endocrinologist of the time, a.k.a. dr. diabetes. his tie usually kept diabetics alive for months beyond their diagnosis, but as living skeletons. elizabeth use would become one of the most successful patients. in 1918 elizabeth was a healthy, adventurous girl with a promising future, but within one year's time everything will change. she would begin showing the classic signs of diabetes, insatiable thirst, ravenous

hunger, rapidly lost. she was a child of privilege, the youngest daughter of charles use here to this day remains the only man in american history to have served as governor, secretary of state, associate justice, and later chief justice of the united states. he is also the only justice of the supreme court ever to resign his position to run for president of the united states. in 1916 hughes ran for president against woodrow wilson. he woke up and had lost the election. elizabeth's parents, charles and antoinette enlisted the help of dr. alan. his notoriety was something of a mixed blessing, like being an excellent and experienced executioner. imagine allan having to get to this extent politician and his wife and telling them, your daughter is going to die. allen told them that he could

prolong elizabeth's life, but she would never eat normally again. every single gram of food would be weighed and regulated. her diet would consist of aches, cream, the stubbles boil three times to rid them of cover hundreds. at times she can send as little as 400 calories a day. allen's motta was test darth is to survive. this was the horrible decision that families were forced to make, choosing between the lesser of two evils for their children. many medical experts at the time believed that it was more humane to allow their patients to eat themselves to death than to subject them to the torture to the starvation diet. elizabeth parents chose to follow aldo's advice and use this most radical of treatments. keeping their daughter alive long enough to benefit from the

breakthrough on the horizon. but at the time the families could not estivation lied ahead with a mediocre graduate of the university of toronto medical school. his name was frederick banting. let me share a small story that tells you a little bit about the man he was. during world war one he joined the canadian army medical corps in the fall of 1918 a piece of shrapnel tore into his right arm. he was immediately ordered into a waiting ambulance. a stretcher after stretcher of wounded soldiers a variety disobeyed his superior in order to stay in treatment. he would stay their wounded for 17 hours during which time his bond became so infected that his doctors threatened amputation. his determination to save lives in the face of seemingly insurmountable obstacles would

serve him well in the years to come. after the board banting returns to canada having few job prospects, he opened his of medical practice. he went 28 straight days without having seen as a single patient. his income for its first month of medical practice was $4. in desperate need of funds he accepted a visit to the opposition as an instructor at the university of western ontario with the salary of $2 an hour. his struggles would lead to his great success. in october while previously -- tediously preparing he read through the november issue of a german and surgery, gynecology, and obstetrics. it was written by a pathologist named moses baron. it was entitled, the relation of the islands of langer hands,

diabetes with special reference to cases of pancreatic the piasters. upon finishing the article banting fell into a deep sleep, and he was awakened at 2:00 a.m. by the force of an idea. he take a small black notebook and sprinkle 25 words that would eventually lead to the solution of a medical mystery and has persisted for thousands of years. he wrote, diabetes like a pancreatic ducks of dock keep dogs alive to tell that scene nine to generically the islets. tried to isolate the internal secretion of these to relieve black assyria. i like to think that he understood the importance of the scribbles because that note still exists today. a library at the university of toronto. his idea was essentially s, by tying off part of the pancreas he helped to isolate the elusive

insulin that they secrete. little did he know, it was not a new idea. researchers before him had tried and failed. even though his idea was not an original one, his persistence led to a solution that was both original and successful. the next day he approached a colleague who suggested that he discussed his idea with one of the greatest authorities on metabolism at the time, dr. j. j. r. mcleod, chairman of the physiology department of the university of toronto. now, these two men could not have been more different. macleod was formal, reserve, a distinguished looking. banting, self-conscious and inarticulate. format beclouds notes on the encounter we note that bad things proposal was hardly well thought out. in his frantic excitement mccloud thought that banting looked like he had wandered in from the nearby psychiatricward. there was something about

panting and commenced macleod to give him a chance. mccloud shows to student research assistants to work alongside banting. these two young men decided to flip a coin to see who would go first. best one. nothing about the research process would be easy for banting. in fact, and the summer of 1921 there was a perfect example. one of the hottest summers on record. in this oppressive heat they began testing banting's theory by operating on the pancreases of dogs. the conditions of the land they worked and were far from ideal. an operating table made of wood, padded linens, a flaw that could not be properly sterilized, and the stench of the lab that was nearly intolerable. after seven weeks they had nothing to show but carcasses. all of their dogs that died forcing them to the crowd the

streets of crop toronto. by the end of the summer they had the first character. they'd the pancreas test to dogs 92 would be given their experimental extract bile 409 would serve as the control. the results of the experiment were unmistakable. today's letter 409 was dead, but 92 will live a remarkable 22 days without a pancreas. upon her death he turned his face away. he later wrote i shall never forget the dog as long as i shall live. i have seen patients die and i have never shed a tear. when that dog died of wanted to be alone for the tears would

fall despite anything i could do. meanwhile elizabeth spent the summer of 1921 trying to live as best she could with a disease that was slowly killing her. she lives vicariously through adventures stories depicting things she hoped to do. despite her condition should plan for the future. in one letter to her mother she wrote of her intent to ride in a hydro airplane along lake george for a 21st birthday. that part there was hardly guaranteed. in fact, it was unlikely. that august her 14th birthday was celebrated, not with cake, but with a huge hat box decorated to resemble a cave covered with pink paper and candles to read elizabeth was so weak it took her 11 tries to block her candles. meanwhile, back in toronto panting made their first presentation to the scientific community. following his lectures

researchers around the world would begin to hear of the enormous breakthrough that have occurred. macleod was finally convinced that bantings best research was worthy of a team. macleod brought on a brilliant professor of biochemistry to assist. but the dissension among the researchers would become so intense that to the stay their exists not a single photograph of the four-man members of the discovery team in a single frame. these four men could not stand, could not even stand together long enough to have their picture taken. about six weeks later on december 28, 1921 banting, best, and macleod told the world about the discovery at the american physiological conference held at yale university. the word had spread about the work being done in toronto, and they were the most anticipated presentation of the day. the audience was packed with

diabetes experts including elliot johnson, frederick allen, and alan clues, a researcher from ely, lily, and company. from reading banting and the clouds accounts of that day we know mccloud introduced panting. he described the research in detail, but repeatedly used the word we. when he finally stood to speak his face was red with rage. those in the audience struggle to hear. he did manage to convey that at that very moment that they were gathered in new haven, conn. there was a diabetic dog named marjorie in toronto who have lived without the pancreas for an unprecedented 42 days. they had kept marjorie alive using an extract made from people pancreases.

after the speech they were approached. a man who instead of spending the holidays with his family in indianapolis had left, christmas morning just to be in attendance that day. he proposed a collaboration between eli lilly and the university of toronto. he believed that if the discovery stayed in a purely academic setting too much time would be spent at conferences rather than saving diabetics. eli lilly believe that the future of pharmaceutical manufacturing late in identifying those research projects with commercial potential. j. k. lee sr., the founder of eli lilly, and his son, the grandson, eli lilly, were prepared to bet the ranch to develop insulin. the lilly philosophy was ideas don't cure people, drugs cure people. panting and macleod rejected, but he would not be deterred.

recognizing the importance of their work he immediately wire at the word telegram to the lily family. this is it. what would become the first collaboration between a pharmaceutical company and a university would not occur until months later. back in toronto the relationship among the researchers continue to unravel. banting felt that the team was pushing him out of the next phase of development and the responsibility for purifying the substance was primarily given to bertram as the best tennis. more doctors were brought on to oversee the clinical trials. a mixed, 65-pound, 14 year old boy in the final stages of diabetes was admitted to toronto general hospital. on january 11th 1922 and a thompson became the first human being ever to be injected with insulin. banting would not be the one to

administer it. not long after lens injections of insulin supply they became too low to continue its human trials. after struggling for months to purify and develop a method for securing an adequate supply the toronto team had failed. they entered into a one year licensing agreement allowing eli lilly to develop the process for the mass production of a usable extract. lilly immediately went to work convincing nearby slaughterhouses to supply the 2,000 pounds of pancreas glands need each week in order to begin production. they told the meatpackers that every pound ship could potentially save a child's life and soon the precious ingredients were arriving by the refrigerator trainload. threat the summer of 1922 the insulin plant would run three shifts a day with over 100 engineers, scientists, and

doctors focused solely on finding a method of mass producing insulin. the let's never went out in the science building, and still they could not meet the demand. positions everywhere were desperate for what was being touted as a miracle drug. in order to motivate the scientists then literally began coming to the laboratories with photographs of their emaciated patients. work in indianapolis proceeded at a fever is great, but with a multitude of setbacks. that july with toronto in desperate need of insulin banting made a frantic trip to eli lilly to procure enough supply just to keep his own patients alive. weon was j kelly. when he was told that he could keep it all and take it back with him banting was so overcome with emotion that he fell on tilly's shoulder and what. after that the lee pledged to

supply toronto with 500 units a week. at the same time news of the discovery was being trumpeted by the press. banting was put in the difficult position of deciding who would receive insulin into would not. he wrote of the almost mythical perception of the drug. diabetics swarmed from all over and he was forced to turn away hundreds who arrived at his clinic and hundreds more who rev him. one of those letters was from elizabeth's mother. she wrote that as of this condition had worsened and she was exceedingly weak. desperate for any kind of help, even if it only meant a brief reprieve so that elizabeth could gain a few pounds. but there simply wasn't enough insulin. even elizabeth, daughter of the united states secretary of state was denied. however, antoinette refused to

give up hope and wrote another letter. at this point in our research we began to realize that charles hughes must have intervened because less than one month later elizabeth would be granted a spot and toronto. her spot would be at the sake of another child. elizabeth recognize that privilege afforded her as the daughter of a famous politician allowed her to receive this miracle serum while some many of the children were denied. in fact tamale three of dr. allen's original 100 patients would survive long enough toeceived insulin. on august 15th 1922 a few days shy of her 15th birthday elizabeth hughes arrived to begin an experimental treatment that could end her 40 month struggle for life. we removed by this moment trying to imagine the magnitude of this. two people who never gave up

hope in the face of impossible odds coming together for this momentous occasion. we could learn a lot about perseverance. elizabeth adhered perfectly, never wavering in her belief that if she could just stay alive long enough a breakthrough could occur that would say for. he acted out of pure conviction giving a newly established medical practice and fiancee to pursue an idea that has come to him in the middle of the night. because of that conviction millions of lives would be saved, and elizabeth would obtain her miracle. having outlived her prognosis by more than two years weighing just 48 pounds, being 15 years old elizabeth sat in bantings office. a hospital gown barely covering her frail frame and she received her first injection. in order to give its injustice i

thought i would give you a brief reading from our book. banting pull the string from around his neck on which there was a key. he bent and open the cabin door. elizabeth could see now that it was a kind of icebox and that there was nothing inside but too small round glass vials. she wants to closely. is that insulin she whispered? yes, he whispered back. he swamper tie with alcohol. she watched until the syringe. elizabeth must have a sense put it at cost banting to become what he was, and carrying the idea of insulin. repeated failure and constant that in doubt all the way to the office in which they said now. perhaps she caught a glimpse of a profound loneliness. in any case she nodded solemnly just before the needle pierced her meager it.

she flinched from but did not look away as banting squeezed the plunger and compressing the murky based extract into her flesh. now the banting nor elizabeth spoke. banting turned away to discuss the empty file. wait, her voice broke the silence. mackey bit? elizabeth's improvement was immediate. she described the experience as an unspeakably wonderful. she would become banting's most famous patient and a veritable poster child for diabetics. but elizabeth just to follow her moment of fame with a lifetime of silence. she married, had three children, took to insulin injections a day and successfully hid her disease from everyone outside her family. she destroyed most of the evidence, even pictures of herself taken while and the ravages of the starvation diet which, as you can imagine, made

her a particularly difficult protagonist to write about. the only tangible evidence we have of her life from 1919 to 1922 is a series of the most remarkable letters ever written by child term mother and father. when she died in 1981 at the age of 73 elizabeth had received some 42,000 insulin injections, more than any other human being at the time. as for banting, his prominence only grew. he was awarded the nobel prize in medicine along with j.j. r. mcleod him. they chose to share their aboard with the other two team members. banting also developed a personal and long-lasting relationship with the children whose lives he saved recognizing but the revolutionary aspects of his discovery in the world of science and the incredible impact it had an individual lives. years later he wrote, i shall

always followed your career with interest, and you will forgive me if i had a little pride because i shall always remember the difficult times we had in the early days of insulin. but tragically banting died 20 years after this life-saving discovery. during world war two while serving as a liaison officer he was killed in the disaster over newfoundland. his legacy lives on in the millions of lives saved. i have now spent seven years immersed in the story and then bringing the story to life. it was important to say that we honor the lives lost, sacrifices of the research team, those who benefited command the suit continued to struggle. even though the landscape of diabetes management has changed dramatically, the discovery of insulin remains just as essential today. looking back on the history can

remind us how far we have come and of the importance of our continued efforts. if there is one thing i want people to take away from the story is that the work being done at any given moment could produce the next breakthrough. thank you very much. [applause] i just want to show you folks a very short video. we are very honored in conjunction with the book. you will have to give me a moment to read friend this computer. let's do that. okay. be -- here we go.

>> okay. kid. >> founded in 1804 to collect documents and artifacts related to the history of new york and particular the united states in general. we have assembled collections for over 200 years reedbuck. >> the exhibition started initially with discussions between us and other aims for, the author of the breakthrough book. at that we decided to work on the discovery of insulin and its distribution. >> many things came from toronto, the institute in boston, others came from the academy of medicine, the rockefeller archives and a multitude of places. >> the exhibit is structured in a circle. you enter and leave from the same door way. we start with what people

thought in the thousands of years before the discovery in the 1920's. exactly before. people went on a starvation diet. the first patient and then the initial production and distribution, then the time after words in which we call minutes, maintenance of the way taken and distributed. we end with today which deals with where we are dealing with the disease today. >> diabetes has been a fatal disease. with the discovery of insulin it became a chronic disease. be part of the discovery.

it was important to discover the hormone itself. also important to establish a way in which it could be useful and used to save lives. >> i think the archival holdings of lilly and jocelyn and toronto are extraordinary. >> a great contribution, and a great collaboration. we often think of the institution. in fact, it was a collaboration between the discoverer's and the producers and distributors that made it possible for insulin to save lives.

>> i think that is the end. thank you very much. [applause] >> thank you so much. we will take some questions at the end. dr. bergman is going to a speech next. again, i think everybody has some information about the exhibit. it is quite remarkable. let you check it out. >> thank you very much. it's a pleasure to be here. a wonderful evening. i appreciate the invitation to participate in the event.

when i first heard of the book and had the pleasure of reading, i attended one of the opening ceremonies. wind through the exhibit. deeply impressive. betcha exhibit is. my comments lazar were prepared or are prepared as at toward with first-year medical students. this is a book that speaks to this, talks about human emotions, the drama. but the most brilliant discoveries. the whole life of a basically very simple with the peak surgeon. mediocre means, had strong, committed to that task, a vision. for the first-year medical

students and certainly for all of us at any age it is an inspiration to take part of revisions and dreams we have an stick to it even though it runs across obstacles, individuals, willing to stick with your dream as you work through it. at least a strong chance of being able to fulfill the dream. i think mr. annenberg for chairing this very profoundly important story, both from the perspective of dr. banting as well as from the elizabeth hughes, very moving, touching story for those of us who see patients with type one diabetes. it can humble as for the nominee how many years we have done this to appreciate how difficult the lives these individuals have. many of the developments in diabetes have been miraculously. when the concept of this evening cam about i thought a follow-up discussion would be on.

at this one to acknowledge dr. ross presence as well. the diabetes research area. i also want to show a video. let me see how i get out of this. >> the winner of 1922, and bantings team was and making small batches of the miracle hormone and administering it to their patients. -- patients. the success stories were tremendous. the countless people worldwide clamoring for a chance to get relief from the starvation diet that had kept them alive just

light enough to see the great discovery. if they could not find a bigger supply of insulin patience to have survived and those who had tasted the promise of insulin would simply waste away and die. >> in the early days we get all of the chilled beef or pancreas that you could and grounded up and began the extraction process. the real problem was how to get it to go from a suit of ground the pancreas to pure crystal pure insulin. the toronto team was overwhelmed, needing more money, better facilities, and most important time to figure out the complex chemical work. time was not something they have on their side. they were running out of insulin, and with limited patient a sure supply of hormone, and no means to mass-produced there seemed an insurmountable gap between healing a single patient and mass producing the miracle hormone. >> the one person who was really

enthusiastic was a man named george clues to happened to be the research director for eli lilly and company of indianapolis. clews said to mccloud and banning comanche, this looks good. you would like to collaborate. >> the canadiens initially declined hoping to resolve production problems on their round, but in disaster. >> the insulin was gone. >> fred banting went back to eli lilly. the large american drug company agreed to take on the challenge of mass producing the hormone for distribution in north america. the results were astounding, changing the lives of people with diabetes forever. danish scientists traveled with a personal interest. his wife had been diagnosed with diabetes. her only hope for survival was the availability of insulin in their home country. he went to ask permission to mass produce it. when the answer was yes he went back to denmark to start what eventually became a noble

motive. >> the two big producers in fact have their roots back in 1922. lilly, because of an enterprising research director, probst wife had become diabetic. he wanted to know how to make insulin said that he could save his wife's life. >> mary survived. when insulin hit the commercial market in late 1923 millions of patients around the world saw a renewed chance of light to read every story was different. certainly representative of the early recipients, five years old living in syracuse new york when he was diagnosed with diabetes. >> my mother said of the skin and bones. >> bob learned that even with insulin treatment for diabetes require rigid management. lucky enough to have a mother up to the challenge. >> occasionally she would have to buy the sliced bread, a slice of that bread was maybe

30 grams. she would have to cut a piece of work at the crest of so that i only had 20 grams. >> reporter: a few years later bobs older brother was also diagnosed with diabetes. >> when i was diagnosed i felt that the world kind of dumped in on me. i was going to have a different kind of life. >> reporter: with two boys suffering from diabetes administering insulin required a bread routine. >> my mother with give it to me. in my legs. after they got out of commission because of so many shots i had it in my arms. >> we had needles that had to be sharpened. boiled up after every use. >> reporter: testing sugar levels required an extreme ethic by today's standards.

no quick blood tests or easy home kits. reading's required boiling urine samples and the test tube. it was not just the mechanics that mitnick with the disease a difficult. life expectancies are measured in weeks, but up to more than 30 years. for the first time ever people were living on insulin with diabetes. they and the people around them were facing a lot of new challenges to be. >> that did not want it to be separated out from the normal group. i would say very little about it. keep it quiet as much as i could. >> we dated for about six months before she found out that i was a diabetic. dislike employers did when they found out. >> reporter: the brothers continue to manage their diabetes. over the next five decades technology created dramatic changes in the way they and everyone else around them lived,

surprisingly little changed in the treatment. >> really no breakthroughs in insulin production, very frustrating for everybody but until in the early 1980's if you went in, they introduced a new era. >> reporter: scientists figured out how to inject insulin genes into self replicating cells. was an extraordinary moment. finally and in the supply of pure human insulin no longer dependent on animal extraction. dna technology has unleashed a whole new wave of development. >> long-lasting, short acting, better and more efficient insulin is available today. home testing devices have gone on long way to give patients more control over their own management. delivery systems have dramatically improved. disposable syringes, pens, pounds. the power of the insulin story is most evident in the children whose lives it saved.

to elizabeth years lived until 1982 and became a wife, mother, and grandmother. some 85 years after fred banting conceived of the craziest idea bob and gerald still walk the streets of their neighborhood. after surviving for nearly 80 years on insulin they stand as shining examples with the power of this discovery in the millions of lives it is saved. >> i have been on insulin for 35 years. thirteen years now. >> twelve and a half. >> eight years. >> a year and two weeks. >> to think of a condition, complete the untreatable. patients died because of the lack of being able to receive insulin, it's inconceivable today. >> insulin is like my best friend.

>> relationships. >> the reality is when i take the insolent i am not different anymore. this is what insulin allows me to do. it allows me as a type two diabetics to be normal. >> insulin allows your body to use what you are eating for energy. without insulin you could not survive. >> days into development of treating diabetes, but the final stage is not the first stage. it's where we are.

[silence] >> okay. all right. we'll move on. november 14th is celebrated as the world diabetes day. that was instituted a number of years ago by the international diabetes foundation. the blue circle stands for the world wide optimistic view of life with type one diabetes. to start our stroll down memory lane this is kind of a blurb from consumers' guide 2010. i would like to show this slide. it will probably say everything. a variety of devices. i can't imagine 50, 60, 80 years ago that you could make statements such as you see here. when you add in insolent palms and the range of other products available for managing diabetes it's easy to get of wrong by the

number of options when you consider how few options there were less than a century ago. the first thing i think we will talk about, and i've read. a round to the first year of students. thank you very much. i did not pick them up at macy's, by the way. we will talk about the development of insulin syringes. since the discovery. a lot of slides that i will go through quickly. mostly graphic so one of the first -- from 1923 you can see that one of the original insulin files housed four species of insulin. a very pure -- it was of very pure -- in pure substance. it was relatively important.

patients required large volumes of this and your extract which often lead to infections at the infection sides. so you already saw this. mr. thompson receives -- can you imagine this, 15 species of the extract using one of these licenses. if you compare it to the current concentration of infant -- and son available for many decades we have a few 100 used per cc. if you gave 15 species of 100 units these individuals, just to give you an idea of the significant change in the concentration and potency of insulin over the decades. deal with kind of a thumbnail sketch of the evolution of insulin. we won't spend any real time on any one of the steps, just to

give you an idea of the development process. very little development, but the initial insolence that was developed was essentially assured acting insulin. patients required multiple injections of a short acting insulin. it really was not until approximately 1936 that it was recognized that if you used zinc sink would prolong the activity of insulin, especially protamine coming from fish and sperm. it was very hard to regulate. neutral protamine a thorn is developed. it is a lawyer acting insulin, 24 hours, still used, actually quite at lot of good insulin in many circumstances. a year later the insolence were developed. they did not use protamine to be essentially a zinc based insulin. in use for many, many years, no longer available. with the refinement and some of

the biochemicals to macy's me, the technological aspects of medicinal chemistry as of 1974 this really revolutionized the ability to both refine and purify insulin. so, by that time in 1975, the fully synthetic insulin. actually recombinant dna technology emerged. 1982, developed the first human insulin both regular and miles-per-hour. and then the scandinavian company novell also developed human insulin called monotype. and then where we are today is about ten years or so or almost 15 years after the development of insulin analog which is basically just a refinement of

the amino acid process developed with a recombinant dna technology. so, we have insulin that we are not going to go through obviously any detail. again, primarily the first-year students, an idea of what is available today less than 100 years after the discovery of a very in pure, and put in substance and how magnificent the variety that we have. unfortunately those that have type one diabetes at least have a variety that are disposable for use. an increasing number of individuals that are tied to patients that are insulin requiring. you have the rapid acting insulin, regular insulin, intermediate, long acting, mixture insulin, a combination of those with different ratios combining different proportions of long acting in short acting. it is an art, and it is really

an art to customize the use of insulin therapy. even with that it still doesn't mimic adequately enough what the national process of pancreatic secretion is which is absolutely very complicated and involves clearly more than justin slauson this slide gives you the different time frames of how the insulin works. we will spend time with this. and then finally the insulin just gives you a panoply of the different variety that have been around for many years. that covers the gamut. the only insolent to my knowledge that is not available is regular insulin available in a file. they are very flexible. they can provide insulin doses as low as they have to. these are the slides, i think some of the video. i won't have to spend much time.

test compare where we are today with the syringe is that only go back before the 50 years. you get the size of this needle, the size of this class syringes. they have to be sterilized. very long needles that often would catch flesh in them and have to be cleaned out. it was quite a development to seek refinement process of meals alone which was actually the hallmark of a lot of the work done over many years. it is not in use any longer, but certainly in the time of my training, insulin inject depends which were kind of brutal, but this is to overcome the fear and phobia of using insulin. this is kind of where we are today. a very small needles, you know, plastic syringes, disposable syringes, files that contain generally ten species of insulin. basically there are other

concentrations. 500 is very rarely used. the variety of different types of syringes, high guess syringes, lotus syringes. and then the different types of needles, penn neal's for individuals that use pens. so, this has evolved very quickly over the years. with regard to electrical monitoring, also shown in the video, this is one of the very early ways of determining glucose levels the only thing that was available was the use of urine testing using the tablet. so use a little bit based on copper reduction, reaction which also could identify other substances rather than glucose,

but essentially glucose. was compared to the color of the year and after putting metabolite and compared to the color chart. this is largely abandon now. one of the things that was clearly recognized of urine testing was the best semi quantitative, did not reflect the blood glucose levels, and also was erratic and unpredictable depending upon the real threshold which could vary depending on circumstances, real function, a pregnancy, and someone. so in the 1980's there were -- the 1980's, developing many types of devices for monitoring capillary blusher levels, a variety of different meters. ames was the first to develop a system that was actually not meant for the patience to read it was not a portable