hiring people. they hire people that are attractive and that they want to me around. . .

when you've got a great voice, when you are the best reporter, when you have stories of the fact things like that. so it's hard to say no to somebody whose excellent, so i want them to be excellent. >> host: thank you so much for doing this. we've got to write the book. i thank you for being here. >> guest: thank you.

one of the first apd's patients with insulin injections in 1982. the new york university school of medicine is the host of this event. it's about an hour. dashed into the world. framed around a young girl named

elizabeth use. it is story of the 10th scientific rivalries come at your site, multiple set tags, which virtually culminated in purified and made available to diabetics everywhere. the discovery of insulin by frederick answering, portion and jay jay r. macleod represents one of the greatest medical advances in history. the development of insulin took about two years. today a new drug takes 10 to 15 years to navigate development and regulatory review. the costs associated with developing a drug is also increased genetically. a new turn today often exceeds a billion dollars in cost. insulin costs $1400 to discover. i have all the invoices. in $250,000 to develop the

process for mass production and clinical review. for me the story is quite personal. in 1975, when i was 28 years old, i was diagnosed with hodgkin's disease. into the early 1960s, hodgkin said benitez sentence. i was fortunate enough to be diagnosed at a time when the treatment was available and i was cured. because of my own experience, i felt a deep connection to this story, to elizabeth use as the one who faced a dire diagnosis to a family who stayed by her side into the researchers whose tireless effort completely changed the odds of survival. the discovered that insulin occurred almost 90 years ago, yet this medical miracle is just as important today as it was on that date was discovered. in fact, there are today nearly 300 million people with diabetes worldwide. her stories begins in 1990, the

youngest daughter of the most famous politician in america has just been diagnosed with what was then a death sentence. juvenile diabetes. according to the mortality tables, she would be dead in 11 months. elizabeth's story, history of the men who kept her alive and at the discoverers is one of hope, courage, determination and miracles. in order to better understand the magnitude of this amazing discovery comments important to know a little bit more about diabetes and history. when you have diabetes, your body either doesn't make enough insulin or can't use the insulin it does produce as well as it should. the pancreas, nor can in the stomach produces the hormone insulin, which helps glucose given the body to be used as energy. if your body is not producing insulin, then you cannot manufacture metabolites glucose. if you're unable to metabolize glucose come you cannot live. diabetes is essentially a beast

accorded effective 1550 dce by the ancient egyptians. the preferred method of treatment included eating a boiled assortment of bones, wheat grain and earth. while this may seem absurd, it's not that far off from the treatment of the early 20th century. for thousands of years, little more was learned about diabetes. then in the 18th century, scientists discovered the sweet sticky substance found in were sugar. in the 19th century, scientists isolated a cluster of cells in the pancreas to secrete hormones, which lowers glucose levels in the blood. this is serious pancreatic secretin was named insulin. despite this new knowledge, in 1918, physicians were still helpless, to prevent the death of those diagnosed. while waiting for a miracle

cure, doctors turn to a radical starvation treatment to prolong the lives of their patients. this radical treatment was developed by frederick madison alan, one of the leading endocrinologist at the time, also known as dr. diabetes. allen's drastic diet usually kept diabetics alive for months beyond their prognosis. but as living skeletonscome elizabeth use would become one of allen's most successful patient. in 1918, elizabeth was a healthy adventurous girl with a promising future. but within one year's time, everything would change. she would begin showing the classic signs of diabetes. insatiable thirst, ravenous hunger, rapid weight loss. she was a child privilege. she was the youngest child of charles evans hughes, who 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 state. 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, charles evans hughes ran for president against woodrow wilson. he went to sleep in kenya was the president. he woke a comma loss california and lost the election. elizabeth's parents, charles and implement the most of the hope of that are alan. his notoriety was some of the next lesson, like being an excellent and experienced executioners. imagine alan having to go to the esteemed politician and his wife and telling them prolonged elizabeth's life, but she would never eat normally again. every single program of food would be weighed and regulated. her diet would consist of eggs, cream, brand rusks and vegetables boiled three times to the rhythm of carbohydrates.

at times she consumed as little as 400 calories a day. balance mondo was to starve is to survive. this was a horrible decision that families were worse 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 and to subject them to the torture of the alan starvation diet. elizabeth's parents show to follow allen's advice and use this most radical of treatment, keeping their daughter alive long enough to benefit from the breakthrough on the horizon. but at the time, allen in the hughes use families couldn't know that starvation went ahead with a mediocre graduate of the university of toronto medical school. his name is frederick symantec. let me share a small story that

tells you a little bit about the man he was. during world war i, he joined the committee in the army medical corps. in the fall of 1918 was a piece of shrapnel torn into his right arm. using we do it order her to a waiting ambulance, but after searcher searcher wanted looters arrived, he distributed his superior in order to stay in truth. he would stay there, wounded 17 hours, during which time his wound became so infected that is taught there is threatened institution. his determination to save lives face seemingly insurmountable obstacles would serve him well in the years to come. after the war, he would turn for canada, having few job prospects he opened his own medical practice in london, ontario. he went 28 straight days without having seen a single patient.

this income for its first month of medical practice was $4. in desperate need of funds coming except to the position as an instructor at the university of western ontario. the salary for the position, $2 an hour. but historical would lead to his great success. at 1:00 in the morning on october 31, 1920, while tediously preparing for the following day's lecture, he raised the november issue of eternal into surgery, gynecology and obstetrics. the article was written by an american pathologist named moses and aaron at the university of minnesota and was entitled the relation of the pilot to linger and to diabetes with special reference to cases of pancreatic upon finishing the article, he fell into deep sleep and was the weekend at 2:00 a.m. by the force of an idea. he took a small black notebook and scribbled 25 words that

would eventually lead to solution of the medical mysteries that have persisted for thousands of years. he wrote diabetes like a compatriot ducks keep dogs alive tuesday night to generate lethe islands. try to isolate the internal secretion of these to really click with syria. i like to think that he understood the importance of those because that still exists today at the rare book library at the university of toronto. his idea was essentially this. by tying off part of the pancreas, he hope to isolate the island of lenker and the elusive insulin basically. little did he know it was not a new idea. researchers before him had tried and failed. even though his idea wasn't an original one, his resistance led to a solution that was both original and successful.

the next day he approached a colleague who suggested he discusses a few of greatest majorities and metabolism at the time, the are jay jay r. macleod, chairman of the physiology department at the university of toronto. now these two men could not have been more different. macleod was horrible, reserve, distinguished looking, self-conscious and articulate. for macleod's notes on the account, the proposal if you could call it that was hardly thought out and in his frantic excitement, macleod looked like he had wandered in from the nearby psychiatric ward. but there was something that convinced macleod to give them achieve. macleod chose to student research assistants, charles passing clerk noble to work alongside him. these two young men decided to flip a coin to see who would go first. nothing about the research is

would be easy. in the summer of 1921 was the perfect example. it was one of the hottest summers on record immunosuppressive heat they began testing and fees vary by operating on the pancreas of dogs. the conditions of the lab they worked and were far from ideal. an operating table made of lead, tattered linens and the stench of the lab that was nearly intolerable. after seven weeks. nothing to show for their work purposes. other dogs had died, forcing them to capture stories. but by the end of that summer, they had their first breakthrough. they pancreatitis two dogs dog 92 and talk for a nine. type 92 would give their

experimental extract while doug for nine would serve as their control. the result of the experiment were unmistakable. doug 409 was barely able to walk while dog 92 was prancing around the lab like a house for. two days later.49 was dead, but dog 92 would live a remarkable 20 days without a pancreas. upon her death, he turned his face away from rats. he later wrote, i should never forget the dog as long as they live. i've seen patients died and i never shed a tear. but when that dog died, i wanted to be alone despite anything i could do. meanwhile, elizabeth spends the summer of 1921 train to live as best as she could with a disease that was slowly killing her. she looked vicariously through adventure stories depicting things she hoped to do someday

and despite her condition she planned for the future. in one letter to her mother, she wrote her intent to write in the hydroplaned along lake george for her 21st birthday. the 21st birthday was hardly guaranteed. in fact, it was unlikely. in august, her 14th birthday was celebrated and not with k., but a huge halfbacks decorated to resemble a cake, covered with paper and candles. elizabeth was so weak it took her 11 tries to blow out her candles. meanwhile back in toronto, she made her first transition on november 14 in 1921. following his lectures, researchers around the world would begin to hear the enormous breakthrough that it occurred. macleod was finally convinced that his research was worthy of a team. so macleod wrote for the brilliant professor to assist in the process, but the dissension

among the researchers would become so intense that to this day there exists on a single photograph of the four main members of the discovery team in the goal frame. these four men couldn't stand -- couldn't even stand together long enough to have their picture taken. about six weeks later in december 28, 1921, macleod told the world about their extraordinary discovery at the american physiological society concert held at yale university. the word had spread about the work being done in toronto and they were the most anticipated presentations of the day. the audience was packed with diabetes experts, including elliot johnson, frederick allen in à la clues a researcher from the lead company. from accounts of that day come when no macleod introduced an team. it describes the research and detail, but repeatedly used the word we, which meant it seemed

like he was trying to take credit for discovery that macleod had little hand in creating. when he finally took to speak on his face is red with rage, his voice is so quiet that those in the audience struggled to hear him. but he did manage to convey that at that very moment that they were gathered in new haven, connecticut, there is a diabetic dog named marjorie in toronto who had lived without a pancreas for an unprecedented 42 days. at best he could marjorie of life is an extract may know from fetal pancreases. after the speech, they were approached by eli lilly, a man who is spending the holidays with his family in indianapolis had left home on christmas morning just to be in attendance that day. clues are posed a collaboration

between eli lilly and the university of toronto. he believed the discovery in a purely academic setting too much time would be spent to conferences, rather than saving diabetics. eli lilly believes the future pharmaceutical manufacturing way in identifying those research projects with commercial potential. jk lilly senior, founder of the eli lilly and his son, grandson eli lily were prepared to bet the ranch to develop insulin. the lowly philosophy was ideas don't care people, drug scare people. they rejected the latest assistants, the clues would not be deterred. recognizing the importance of their work, he immediately wired a three word telegram to the lowly family. this is it. what would become the first collaboration between a pharmaceutical company in the university wouldn't occur until months later.

back in toronto, the relationship among researchers continue to rabble. the phallic famous pushing them out of the next of development and responsibility for. find the substance was primarily given as the best tennis in more doctors are brought on to oversee clinical trials. amidst this drama, a 65-pound 14-year-old boy in the final stages of diabetes was admitted to toronto general hospital. on january 11, 1922, leonard thompson became the first human being ever to be ejected with penicillin. painting would not be the one to administer. not long after leonards injections of insulin supply became too low to continue with human trials and after struggling for to purify and develop the method of securing adequate supply, the toronto team had failed.

so they entered into a one-year licensing agreement having eli lilly developed a process for the mass production of useful extract. lily immediately went to work in convincing nearby slaughterhouse is to supply the 2000 pounds a pancreas gland each week in order to begin production. they told the meatpackers at every township could potentially share the child life and sin the pressures were arriving by the refrigerated team. throughout the summer of 1922, the insulin plant the eli lilly would rent she ships the day had 100 scientists and doctors focused only on finding a good of mass-producing and going. the lights never went down in the science building until they could not meet the demand. physicians everywhere were desperate for what was being touted as a miracle drug. in order to motivate the

scientist, they literally began coming to the lowly laboratories with photographs of the mec to patients. work in indianapolis proceeded at a feverish rate, but with a multitude of effects. at july, with toronto in desperate need of insulin, he made a frantic trip to eli lilly to procure enough supplies just to keep his own patients alive. waiting for him at the train station was jk lilly and 150 unit of insulin. when he was told that he could keep it off and take it back within, banting was so overcome that befell unto lowly shoulder shoulder and went. after that, lily fledged to supply toronto with 500 unit week. at the same time, news of the discovery was made trumped by the press. banting was put in a difficult position of deciding who would receive insulin in who would not. he wrote of the almost mythical perception of the drug.

diabetics were an think we could conjure the extract from the ground. he was forced to turn away hundreds who arrived in funds and hundreds more who wrote in. one of those letters was from elizabeth's mother, antoinette. she wrote the elizabeth's condition had worsened and that she was six days a week and wasted. internet was desperate for any kind of, even if it only meant a brief reprieve so was the best could gain a few pounds. but there simply wasn't enough insulin and even elizabeth, daughter of the united states secretary of state was denied. however, and when it refused to give up hope and wrote banting another level. at this point in our research, we began to realize that charles evans hughes was on george's behalf because less than one month later elizabeth would be granted a spot in toronto. her's that would be at the sake of another child.

elizabeth recognize the privilege afforded her a daughter of a famous politician, allowed her to receive this miracle serum why so many other children were denied. in fact, only three of dr. allen's original 100 patients with survived long enough to receive insulin. on august 15, 1922, a few days shy of her 15th birthday, elizabeth hughes arrived to begin an experimental treatment that could enter 40 month struggle or it could end her life. we were removed by the sword in a research trying to reach the magnitude. two people who never gave up hope of impossible odds coming together for this homages occasion and medical. we can learn a lot about perseverance from banting and elizabeth. elizabeth figured perfectly to balance diet. never wavering in her belief if

she could just stay alive long enough to break through that could occur. leaving the newly established medical ascendancy on a to pursue an idea that they come to him in the middle of the night. because of that conviction, the units 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 that in banting's office, the hospital gown barely covering her frail frame as she received her first injection. in order to give it some justice, i thought i'd give you a brief reading from her book. he pulled the string from his neck in which there was the key. he bent to allow cabinet in the corner of the room and opened the cabinet door. elizabeth could see now what was the kind of icebox and that there was nothing inside it to

small brown glass bottles. she watched him closely. is that insulin, she whispered? yes, he whispered back. he saw goodbye with alcohol. she watched him fill the syringe. elizabeth must have sensed what caused banting to become who he was. what it cost in to cause the idea of insulin against impossible odds repeated failure and can't didn't fit in value, on the way to the office in which they sat now. or perhaps you could eclipse of a profound loneliness behind his eyes. in any case, she nodded solemnly, just before the needle pierced her maker had. she flinched but did not look away for banting squeezed the plunger, pressing them or keep-based extract into her flesh. neither banting nor elizabeth spoke. banting turned away to describe the empty vial come wait for less the science, may i keep it.

elizabeth improvement was immediate. she described the experience as unspeakably wonderful. and she would become the most famous patient, the veritable poster child for diabetics. but elizabeth chose to follow her moment of fame at the lifetime of silence. she married, had three children, took to insulin injections a day in successively hid her disease from everyone out tighter family. she destroyed most of the evidence, waving pictures of herself taken while in the ravages of the starvation diet, which as you can imagine, made her a particularly difficult protagonists 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 a child to her 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, for his work with insulin he was awarded the nobel prize along with jay jr macleod and they chose to share their words with the other two team members. banting also developed a personal and long lasting relationship with the children whose lives he saved, recognizing the revolutionary aspects of discovery in the world of science in the incredible impact it had on individual lives. years later he wrote one of his patients, i shall always follow your career with interest and you'll forgive me if i add a little price because i shall always remember difficult times we had in the early days of insulin. tragically, banting died about 20 years after his life-saving

discovery. during world war ii, will serve as a liaison for u.s. killed in an air disaster over newfoundland, but his legacy lives on in the millions of lives he saved. i have now spent seven years immersed in the story and then bring in the story of insulin to life, it was important that we honor the lives lost, sacrifices of the research team, those who benefited and those who continue to struggle today. even though the landscape of diabetes management has changed dramatically, the discovery of insulin remains just as essential. looking back on the history can remind us how far we've come in to the importance of our continued effort. if there's one thing i want people to take away from the story, it's 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 because we are very honored in conjunction with our boat and you have to give me a moment to reframe this computer, which is now wherever it is. [inaudible] [inaudible] ♪ >> the new york historical society at artifacts related to the history of new york in

particular in the united dates in general. and we've assembled collection for now over 200 years. >> it started initially with discussions with the author of the great books. either that we decided to work on the people that were involved with the discovery of insulin. >> many things came from the university. many came from the joslin institute in boston. others came cremate having a of the rockefeller archives and a multitude of places. >> be said that a structure you venture in may from the same doorway. we started really with what people thought in the years before this discovery in the 1920s. we have a 15th century illustrated book that talk about how doctors of that. identify diabetes.

then, people went on what was called a starvation diet and then the discovery itself. then the first patient. then the initial production and distribution. in it. afterwards in which we call maintenance. the maintenance of the weights taken and distributed in manufactured. and we end with today, which deals with where we are in dealing with disease today. >> diabetes has been a fatal disease. the discovery of insulin, was a chronic disease, but a lot of responsibility for health plan that patient. they have to participate. and it's not something that everybody wants to do. this is really part of the story of discovery of insulin. it was important to discover secretion of the hormone itself, but it was also important to establish a way in which it could be useful to save lives. >> i think the archival of lily

and jocelyn and toronto are extraordinary. >> it was a great contribution and a great collaboration. we have the ink of institution does in opposition to one another. in fact, it was the collaboration between the discover and producers and distributors have made it possible for insulin to stabilize. ♪ >> a tank that's the end. thank you very much. [applause] >> thank you so much. we'll take some questions at the

end. .there bergman is going to speak next. again, i think everybody has the information about the exhibit is quite remarkable. i really recommend that you check it out if you can. dr. michael bergman. >> thank you very much. it's a pleasure to be here. it's a wonderful evening. i appreciate the invitation from the diabetes curriculum to participate in the event. when i first heard of the book and had the pleasure of meeting mr. amesbury, he attended one of the opening ceremonies at the new york historical society, went through the deeply impressive, very moving and firing.

my comments largely were prepared or are prepared and directed towards the first german to close demand, the city who want to listen also are more than welcome. this is a book in the exhibit also i think speaks to this as a book that talks about human emotions, drama. most of us think the most thrilling discoveries in life are by brilliant people that have all the riches in the world, are the glory and it's a humbling experience to the whole life of the basically various ankle orthopedic surgeon with mediocre means, but very headstrong, very committed to a task vision. i think for the first year medical student and certainly all of us at any age, it's inspirational to take whatever vision and dreams we haven't take to it, even though in times we run across obstacles, individuals at the center's and you work through it because at

least it's a strong chance of being able to fulfill dreams. i think mr. ainsberg for sharing this, important story, both from the perspective of dr. banting as well as from elizabeth hughes. it's very moving, touching story for those of us who see patients with type one diabetes. it almost is further no matter how many years were doing this to appreciate how difficult the lies these individuals had. i think many of the development of diabetes has been miraculous. so when the content of the evening came about, to follow discussion would be on the discovery in a very important colossal discovery of the time and one of the other major discoveries that has taken place since then. i also want to acknowledge dr. roth's presence here as well in terms of science intellectual diabetes research area i think it is one of the giants in this

area for many decades. i also want to show a video. let me just see how i get out of this. ♪ >> by the winter of 1922, banting steamers and making small batches of hormone and administering to patients. as a stories were remarkable, but the toronto team could barely keep up with the small number of patients in clinical trials. what was worse was the callous people worldwide, clamoring for a chance to get rid leave a starvation diet but kept them alive long enough for the great discovery. if they couldn't find a bigger supply of insulin, to patients who had survived and those sweet taste of the of insulin would simply waste away and die. >> in the early days, you've got all the fuel for pancreas that

shoots a venue grounded out and begin the extraction process. the real problem was how to go from a suit of grounded pancreas to peer or -- crystal pure insulin. >> to toronto team is overwhelmed. they needed more money, better facilities and time to figure out the complex chemical work. time is not something they had on their site. they were running out of insulin and it was a short supply of hormone and no means to mass produce, there seemed insurmountable gap between healing a single patient and mass-producing numerical hormone. >> one person who is enthusiastic with a man named george clues who happen to be the research dirt for tea light lily co. of indianapolis. he said to macleod in banning, jesus looks good. we like to collaborate with you in developing it.

>> and disaster. the insulin was gone. fred banting went back to eli lilly and the large american drug company agreed to take on the challenge of mass-producing the hormone for distribution in north america. the results were as adding, changing the lives of people with diabetes forever. meanwhile, danish scientist, augusta crowe traveled to toronto with an interest. his wife marie had been diagnosed with diabetes and kroger only hope for survival is the availability of insulin in their home country. he went to toronto to ask permission to mass produce. with the answer is yes you back to denmark to stare would eventually became garbled nordisk. >> the producers have their roots back in 1922. lilly because of an enterprising research your. merck is because his wife had become diabetic and he wanted to know how-to make insulin so he

could save his wife's life. marie krogh survived and went insulin hit the commercial market in late 1923, lives of people around the world saw a renewed chance of life. every story was different, but bob cleveland is certainly represented with early recipients. he was five years old evidence he accused new york when he was diagnosed with diabetes. >> i father said of his skin and bones limited to the hospital. >> dobler and jan for treatment for diabetes required rigid management. he was bucking up to a mother up to the challenge. >> occasionally she would add a slice of bread, maybe 30 grams, so she'd have to cut a piece off or cut the cost of soil that 20 grams. >> a few years later, his older brother was also diagnosed with diabetes. >> when i was diagnosed, i felt that the worst kind is dumped on

me and i was going to have a different kind of life. >> the two-way suffering from diabetes and administering insulin with superhero team. >> morning, noon and dinnertime. my mother would give it to me in my legs and then after they got out of commission because of so many shots, i had it in my arms. >> we had needles that had to be sharp and with bledsoe and oiled up after every use. >> testing sugar levels required extreme effort by the standards. no quick blood tests are easy home kit. readings required boiling samples that tested with chemicals multiple times each day. >> it wasn't just mechanics that made that in with the face of difficult. i've expected these were measured in weeks, they're up to

more than 30 years. for the first time ever, people are living on a plan with diabetes. then the people around them were facing a lot new challenges. >> i did like to be separated out from the normal group. and so i would say very little about it and keep it quiet as much as they could. >> we dated for about six months before she found out that i was a diabetic and then i had to back off. just like in players did when they found out. >> brothers continue to manage diabetes. over the next five decades, it created changes in the way they never knows when that much, but surprisingly little changed in the treatment of diabetes. >> really know for a truce in insulin production for a very for everybody. until in the early 1980s, weatherly introduced insulin from you entered a new area. scientists figured out how to reject insulin genes through dna

recombinant afp. it was an extraordinary moment. finally an endless supply of pure human insulin no longer dependent on animal extraction. dna type knowledge she had released a whole new wave of development, long-lasting, short action, more efficient insulins are available today. home testing device does have gone a long way to give patients more control over their own management. delivery systems have dramatically improved. thinner needles, disposable syringes, ponce. the power of the insulin story is most evident in the children whose lives it made. elizabeth hughes lived until 1982 and became a wife, mother and grandmother. some 85 years at her fred banting conceited or crazy idea about venture of cleveland still

walks the streets of their syracuse neighborhood. after surviving nearly 80 years on insulin, they stand a shining example of the power of this discovery in the millions of lives saved. >> i've been on insulin for 35 years -- 26 years. >> a year in two weeks. >> to think of the condition that prior to discovery of insulin was completely untreatable. patients died because of the lack of being able to see events when it's inconceivable today. >> my insulin is like my best friend. >> it's a love-hate relationship. >> the reality is we are not to drink anymore and this is what insulin allows me to do. it allows me as a type two diabetic to be normal.

>> insulin is a comical that allows your body to use which are eating for energy. but without insulin you couldn't survive. >> it's a stage in the development of treating diabetes. from the final stage, not the first stage, but it's where we are. >> so we will move on. november 4th team is celebrated as world diabetes day which was instituted number of years ago by the diabetes federation and the blue circle

stands for the worldwide optimistic view of life with type one diabetes. to start our stroll down memory lane, this is a kind of word from consumer guide 2010. as they show the cited of food probably hates everything. variety of devices. i can't imagine 50, 60, 80 years go you could make statements. when you add insulin pumps include close monitors in range of products available for managing diabetes, it's easy to get overwhelmed by the number of aceh, considering how few options there were less than a century years ago. the first thing i'll talk about and actually brought some items to pass around the first-year

students if i could just get them back. thank you very much. i didn't pick them up at macy's by the way. we'll talk about development of insulin, different syringes. since the discovery, i'll probably go through many of these quickly. they are mostly graphic and basically just -- so this is from 1923, so you can see one of the original insulin vials had four cc of insulin. it is very purer -- it is a very purer -- and pure substance. it was relatively impotent, so patients required large extracts that often lead to infections at the injection site. so you are the softest. so mr. thompson received 15 cc

that the extract using one of these large syringes, seven in iccs in each, compared to the current concentration that's been available for many decades. we have 100, which means there's 104 cc. if you gave 15 cc the 100 unit, individuals today with the 1600 units of insulin to give you an idea of the significant change in the concentration and potency of insulin over the decades. we'll give you a kind of thumbnail sketch of the evolution of insulin. they won't spend any real time and will just give you an idea of the development process over many years. for many years where there is very little development, but the initial insulin love those that were developed with essentially a short insulin, so patients required multiple injections. it really wasn't until approximately 1936 that it was

recognized that if you use think, think would prolong insulin, specially protamine coming from fish. it was very hard to regulate in 1936. in 1950, mutual protamine was developed. it is 24 hours, still used, quite good insulin is certainly in many circumstances. a year later, the anti-insulins were developed. they did not use protamine. this essentially is an east insulin used for many, many years. no longer available. with the refinement and some of the biochemical -- excuse me, the technological aspects of medicinal chemistry, as of 1974, this really revolutionized the ability to both refined and purified insulin.

somebody came in 1975 it was fully take insulin. in 78, the technology emerged. in 1982, delete developed the first human insulin, both regular and ph. and then the scandinavian company also develops human insulin called packrat did amend where we are today is about 10 years urso, almost 15 years after an analog, which is basically a refinement of the amino acid developed with a recombinant dna technology. so we have insulins that were not going to go through obviously any detail. they primarily are the first-year students of an idea

of what is available today, less than 100 years after discovery of a very impure, imposing substance and how might it to send the variety of insulins we have. i guess maybe that's not the best word to use, but those who have type one diabetes have a variety of influence that are at our disposable spending an increasing number of individuals that are type two patients better insulin requiring. so you have the rapid insulin, intermediate, longnecked team, mixture influence on a combination from different ratios combining various performance of long acting and short acting insulin. it is an art to customize the use of insulin therapy of individuals with diabetes. with that, it still does not mimic adequately enough with the natural process of pancreatic secretion is, which is very complicated and involves more

than insulin alone. this site gives you the different time frames that have insulins were. were not going to spend time at this. and then finally, the insulin to give you a panoply of the different variety that has been around for four many years to cover the camera, the only conflict my knowledge not available as regular insulin dose available in the file. the pens are very flexible. they can provide insulin and doses as low as one have ceased the. this is a slide with the video to compare where we are today with the syringes that only go back maybe 40, 50 years. if you look at the size of the nino, says that the class arranges, they have to be sterilized. fair. long needles and often have to

be cleaned out with me knows. it is quite a development, just the refinement does that mean those, which is the hallmark of a lot of work done over many, many years. there were certainly in the time of my training, insulin injector pens, which were kind of brutal, but this is to overcome the fear and phobia of using it to win. and this is kind of where we are today. a very small needle pair plastic syringes come and poseable syringes and vials that contain generally insulin. they're are their concentrations of insulin, which is very rarely used. a variety of different types of syringes, low-dose syringes, haida syringes depending on the patient. and then the different types of needles. pending bills for individuals to

use pens. this has developed very, very quickly over the years. with regard to blood sugar monitoring, also shown in the video, this is one of the very early ways of determining glucose levels wasn't before capillary documents were available, the only thing available were disposable individuals with the use of testing using the tablet. a little bit of chemistry was based on copper reduction reaction, which also could identify other substances of glucose. so it was compared to the color of the gear in after putting tablet. this was largely abandoned now. one of the things that is clearly recognized with testing

was the blood glucose levels and also was erratic and unprotect to go depending on internal threshold for the posts which could vary depending on circumstances, pregnancy and so on. so in the 1980s, it was an impetus for developing many different types of devices for monitoring capillary blood sugar levels. a variety of different leaders. a company that was the first to develop a system that was actually not meant for the patient with portable devices for patients to be able to use. there were other companies that also developed other devices then there was the visual comparing come stripes to the vials. if you just look at what the

commodore. at that time he needed not only strips. you needed control solutions, towels, wash bottles. it took more than a few seconds to be able to -- for the strips to be developed. if you look at the cross of these reflecting theaters in $1984 kind these meters for $150 at that time. the cost of the meters have come down dramatically. because of strips have been around the same. right now the average cost of the strip could be anywhere from 50 cents to 60 cents, but the cost of meters have gone down tremendously. so this is the way the can strips were in the way we did it for many years. sorry to date myself, that basically to put it had a strip

and so we had file. if it didn't quite match the chart on the bus come you have to intrude really. see you at a range. you didn't have an extraordinarily accurate precise method. this is a picture of the first meter. you see how large. this is not meant for patients to keep things at home or in offices. again, this is the development from the 1980s. so it became very commercially viable and successful. seven inches in length approximately. this is another generation. so the meters got taller, more refined. this is the original, so you can see the pad. pads are fairly large. it had to be completely covered with blood, bbq baited for one minute and wash off and then you could compare the strip with the color chart on the viola or

ultimately the same strip could be inserted into a meter. underfoot in theater, meters got smaller. the meter was very, very popular, still is. different phases. and i brought some samples along of different meters that are currently used. for people who don't want to use strips, this is a two-meter. there is a way not measuring a one phase either a homer in the office as well. and this is one of the more recent development and actually brilliant tool is not a salesperson, but the contoured usb that works very easily, so you can insert the strip on one end. the meter retains the levels and

then the values can be downloaded to the computer to create files in the files can be sent to the physician's office. so this is on the stand for the 1980s to where we are today. so this is also a technology. these are how patients draw blood from the fingers. this is the guillotine. as for the out of whack -- actually the rational model, if you look at the size of the nato, it was extraordinarily painful. patients actually hated it. they left fingers calloused, black and blue. someone do for a framed version of the same thing develop a platform be removed so you could put in different platforms depending on the size and penetration of the needle. and this is where we are today in terms of different devices. very, very small nee