Type 1 diabetes (T1D) research is now accelerating at a quick pace – but it wasn’t always this way. Discover the history of this chronic condition, as well as major milestones that have brought us ever closer to finding cures.
Type 1 diabetes in ancient times
The Ebers papyrus, from around 1500 BCE in Ancient Egypt, describes what seems to be T1D, mentioning a condition that causes excessive thirst and urination (2 of the 4Ts that are signs of T1D: thirst and toilet).
A book of Ancient Chinese medicine from around 2000 BCE also references a condition which translates to ‘wasting-thirst’ (thinner and thirst of the 4Ts).
Around 500 CE, people in Ancient India used an early urine test to check for diabetes. They found that if ants came to someone’s urine, it had high sugar (glucose) levels. They called this madhumeha – ‘honey urine’.
By the 5th century CE, people in India and China had discovered the difference between type 1 and type 2 diabetes.
Discoveries & diets of the 1800s and early 1900s
In the late 1800s and early 1900s, scientists tried a variety of diets to try to treat T1D. Bernhard Naunyn locked his patients in a room for 5 months to achieve “sugar freedom”. If eliminating carbohydrates from their diet didn’t help, he moved on to reducing calories and proteins.
In 1919, Frederick M. Allen advocated fasting for 2-10 days, followed by a restricted calorie diet consisting of mainly fat and protein. Carbohydrates were only given if they were absolutely needed to keep the patient alive. If diabetes symptoms reappeared, it was back to fasting. Some patients starved to death, and even those who followed the diets could only expect to live for about a year after diagnosis.
But this period wasn’t all about diets. In 1889, Joseph von Mering and Oskar Minkowski learnt that removing a dog’s pancreas would cause diabetes. This was a game-changer, as it helped scientists understand how the pancreas regulates blood glucose levels.
And 21 years later, Sir Edward Albert Sharpey-Schafer found that diabetes developed when the pancreas didn’t create a particular chemical. He called it insulin, meaning ‘island’, because it’s made in the cells in the islets of Langerhans in the pancreas.
The early days of insulin
In 1921, at the University of Toronto, doctors Frederick Banting, Charles Best and JJR Macleod achieved a huge breakthrough: they successfully isolated insulin from canine test subjects.
Just 6 months later, insulin was administered to the first ever human patient: Leonard Thompson.
Leonard became the first person with T1D to receive an insulin injection on 11 January 1922. At the time, the 14-year-old was 180cm, weighed just 29kg and had been in and out of a diabetic coma at Toronto General Hospital. His daily dietary intake had been reduced to just 1800 kilojoules.
The first form of insulin didn’t help. But a second version, purified by Dr James Collip and given on 23 January 1922, helped restore his blood glucose levels and alleviate his symptoms.
The effect was seen straightaway, as Dr Banting wrote, “The boy became brighter, more active, looked better and said he felt stronger.”
Leonard lived another 13 years using insulin. Unfortunately, at just 27, he passed away due to pneumonia, which was thought to be a complication of his diabetes.
In a truly generous act, the doctors sold the patent for insulin to the University of Toronto for just $1. They believed that everyone who needed it should be able to access it. In 1923, doctors Banting and Macleod were awarded the Nobel Prize in Physiology or Medicine. They shared their prize money with doctors Best and Collip.
Major T1D breakthroughs have been made in the past 100 years...
1920 and 1930s
Developments in injection and treatment guidelines
Insulin becomes available to buy in 1923. In 1926, the UK Medical Research Council recommends daily insulin injections, timing injections after meals, and regular blood glucose checks. A few years later, doctors start recommending using different injection sites to help absorption.
Patients like Teddy Ryder (shown in photo before and after insulin treatment) show huge improvements.
1946
First longer-acting insulin is developed
Neutral Protamine Hagedorn (NPH), an intermediate-acting insulin that provides glucose-lowering effects for up to 12 hours, is developed by Novo Nordisk. It reduces the number of daily injections needed. The medication goes on sale to the public in 1950.
1963
First prototype of an 'insulin pump' is created
The earliest insulin pump prototype – which delivered glucagon as well as insulin – is created by Dr Arnold Kadish in the US. It's the size of a backpack.
1974
First insulin pump used by a person with T1D
The first insulin pump, the Biostator, is a 60kg bedside device about the size of a microwave. It measures blood glucose levels and dispenses insulin, and it's mainly used to treat severe diabetic ketoacidosis (DKA).
1976
Creation of haemoglobin A1c (HbA1c) test
A Breakthrough T1D-funded researcher, Anthony Cerami, PhD, showed that haemoglobin can be used to more effectively measure blood glucose level management. This discovery led to the creation of the haemoglobin A1c (HbA1c) test.
1978
First human insulin is developed
Breakthrough T1D-funded research leads to the creation of synthetic 'human' insulin in the place of animal insulin. This is a big leap forward for T1D research, leading to a lower risk of immune reactions and better blood glucose control. First marketed as Humulin in the US, this becomes available in Australia in the 1980s.
1979
First battery-powered glucose monitor is created
Inspired by his young daughter's T1D experiences, British-born, Sydney-based Stanley Clark invents the first portable glucose monitor. Before this, blood glucose monitoring required visits to hospitals or clinics, or laborious urine testing.
1983
First implantable insulin pump is made commercially available
The first implantable insulin pump is developed and commercialised.
1985
First insulin pen is sold
The first insulin pen, made by Novo Nordisk, is put on the market. This gives people a more precise way to give themselves insulin when needed.
1989
First islet transplant takes place in humans
Breakthrough T1D-backed researcher Paul Lacy, MD, PhD, performs the first islet transplant in humans.
1999
First continuous glucose monitor is created
Medtronic's MiniMed is approved by the FDA in the US, but it has a limited wear time of around 72 hours and isn't intended for everyday use. It requires finger-prick calibrations every few hours.
2014
Stem cells converted into insulin-producing beta cells for the first time
Doug Melton, PhD, a Breakthrough T1D-backed researcher, creates a protocol in which human stem cells convert into insulin-producing beta cells in the lab. This quickly accelerates the conversion process.
2015
Development of a T1D staging classification system
Breakthrough T1D leads the charge to create a T1D staging classification system. This helps identify the earliest stages of T1D, allowing for more accurate tracking of disease progression and improved design of clinical trials to prevent it.
2016
World's first 'artificial pancreas' system approved
The Medtronic MiniMed 670G hybrid closed-loop system from Medtronic is the first approved technology to automate insulin delivery and lower high blood glucose levels. Breakthrough T1D contributed at every stage, providing vital funding and partnering with the FDA in the US to shape the regulatory pathway.
2017
CGM use in pregnancy shown to improve health outcomes
A trial funded by Breakthrough T1D and the Canadian Institutes of Health Research (CIHR) shows that continuous glucose monitor (CGM) use before and during pregnancy improves health outcomes for both mums and their babies.
2019
Disease-modifying therapy delays onset of T1D
Teplizumab, an anti-CD3 monoclonal antibody, is found to delay the onset of T1D by about two years in people at risk of the condition.
2021
Australian T1D National Screening Pilot is launched
A pilot program is launched to help embed childhood screening for T1D into routine care in Australia. Early identification of people at risk will help lower rates of diabetic ketoacidosis, and can help get them early access to emerging therapies that can delay the condition's progression.
2022
First disease-modifying therapy for T1D approved by FDA
In the US, the FDA approves Tzield, the first disease-modifying therapy – designed to slow, halt or even reverse the progression of a condition – for people at risk of developing T1D. This research has been been supported by Breakthrough T1D for decades.
2022
Autoantibodies recognised as an indicator of T1D risk
Health authorities now recognise that blood-based autoantibodies can be used to identify individuals at risk of developing T1D. Breakthrough T1D has supported this research for decades, hoping to improve early detection and reduce serious complications like diabetic ketoacidosis (DKA) at diagnosis.
2025
Transplanted islets work without immunosuppressives
Sana Biotechnology shares major news: the first person with T1D who received donor islets engineered to evade the immune system is now producing insulin without immunosuppression. This project is supported by the T1D Fund: A Breakthrough T1D Venture.
