Bradwel Stuart. Insulin: A Hundred-Year History

Polity Press, 2023. — 340 p. — ISBN: 978-1509550722.In 1922, an unlikely team of researchers in Toronto made one of the most important medical breakthroughs of the century: insulin. Their discovery seemed miraculous. When it was given to diabetic patients on the brink of death, their condition rapidly improved. Those present could barely believe their eyes: they had witnessed the resurrection. However, this was no simple cure. Injections must be taken for life. Without them, symptoms quickly return, often with fatal results. But while a lifetime on insulin poses great challenges, it also offers opportunities. In this revelatory history, Stuart Bradwel looks back on one of medicine’s most celebrated innovations. Setting a professional narrative against subjective patient experience, he tells the story of a drug that has challenged many of the basic assumptions upon which medical practice is built, both inside and outside the clinic. Nevertheless, Bradwel reminds us that the centenary of this apparent “wonder drug” should be no cause for celebration. Insulin often remains inaccessible to those who need it most: elusive prescriptions, uneven availability, and sky-high prices result in rationing and desperate do-it-yourself research and development. In the face of bootstraps rhetoric and “Pharma Bro” capitalists, patients across the world are left to fend for themselves. There is a long way to go in the twenty-first century until insulin truly fulfills the extraordinary promises made by its discovery.Introduction: What Is Insulin and Why Does It Matter?
Insulin and Diabetes.
A (Very) Short History of Diabetes Before Insulin.
Insulin at One Hundred.
Toronto, 1921 – 1923
Banting’s ‘Eureka’ Moment.
The Early Experiments.
The First Human Trial.
The Reaction.
The Aftermath.
Evaluating Toronto.
Insulin in Practice, 1922 – 1978
The Early Insulin Era.
Life on Insulin.
Free Diets.
The Reassertion of ‘Orthodoxy’.
‘Intensification’, 1976 – 1993
Deus ex machina?
‘Self-Adjustment’.
The Diabetes Control and Complications Trial (DCCT).
Düsseldorf.
Proto-Intensification.
Subjectivity, Paternalism, Neoliberalism, 1993 – 2002
Subjectivity.
Paternalism.
Neoliberalism.
The Insulin Crisis, 2002 – Present
Moralism and Prejudice.
Power and Profit.
It’s Not Just The Cost.
An International Problem.
Conclusion: Insulin for All?