Rationale of the Week | The First Person to Receive Insulin?

This month, we are quizzing test takers on the history of diabetes and the discovery of insulin. Our November 2nd Question of the week quizzed test takers on the first insulin injections in humans. 47% of respondents, chose the best answer. We are excited to share this info with you in celebration of National Diabetes Month.

Before we start though, if you don’t want any spoilers and haven’t tried the question yet, you can answer below: Answer Question

Question:

Which of the following statements is true regarding the first experiments using insulin in humans?

Answer Choices:

  • Since insulin worked successfully on dogs, no experimentation was needed on humans to gain approval.
  • Leonard Thompson, a 14-year-old received the first successful insulin injection in January 1922.
  • The initial insulin was derived from the exocrine cells of ligated canine and porcine pancreases.
  • Elizabeth Hughes was the first insulin recipient in 1921 but the insulin formulation didn’t work to lower her glucose until 1922.

As shown above, the most common choice was option 2, the second most common answer was option 3, then option 4, and finally option 1.

Getting to the Best Answer

If you are thinking about taking the certification exam, this practice test question will set you up for success. Test writers anticipate possible answers based on the details in the question. They will wave those “juicy answers” that seem so familiar to you, right under your nose. Your job is to weed through, eliminate FALSE answers and then choose the BEST answer.

Answer 1 is incorrect. 8.16% chose this answer, “Since insulin worked successfully on dogs, no experimentation was needed on humans to gain approval.” Insulin’s approval was certainly fast tracked, but experiments were conducted on animals first, than humans, before releasing for widespread use and saving the lives of millions.

Answer 2 is correct. 47.77% of you chose this answer, “Leonard Thompson, a 14-year-old received the first successful insulin injection in January 1922.” YES, great job. On January 11, 1922, Leonard Thompson was the first person to receive insulin when he was only 14 years of age. The first injection caused an allergic reaction due to impurities. After James Collip improved the insulin refinement process, the second dose of canine pancreas extract was delivered to the young patient twelve days after the first. Thompson’s health rapidly improved and he lived another 13 years on insulin injections, dying at the young age of 26 due to pneumonia.

Answer 3 is incorrect. 27% of respondents chose this answer, “The initial insulin was derived from the exocrine cells of ligated canine and porcine pancreases.” This is a juicy sounding answer! However, insulin was derived from the endocrine cells of dogs, ox and porcine, to produce insulin; not the exocrine cells that produce digestive enzymes.

Finally, Answer 4 is incorrect. 17.06% chose this answer, “Elizabeth Hughes was the first insulin recipient in 1921 but the insulin formulation didn’t work to lower her glucose until 1922.” Another juicy answer since it has some elements of truth, however Elizabeth was not the first person to receive insulin therapy. Elizabeth developed diabetes in 1918 at age 11 and by the fall of 1922, she weighed only 45 pounds, due to her body’s inability to store energy and the strict 800 calorie diet she followed to prevent ketosis. Elizabeth arrived in Toronto in August 15, 1922 and received insulin injections from Dr. Banting and she recovered rapidly. She returned home to Washington D.C . Thanksgiving Day 1922 on a 2200 calorie meal plan and insulin injections. She lived to the age of 73, and received over 42,000 insulin injections over her lifetime. You can read more in the book, Breakthrough, which chronicles Elizabeth Hughes, the discovery of insulin and the Making of a Medical Miracle.

More Reading on the Discovery of Insulin

The Discovery of Insulin – Vecchio I, Tornali C, Bragazzi NL, Martini M. The Discovery of Insulin: An Important Milestone in the History of Medicine. Front Endocrinol (Lausanne). 2018;9:613. Published 2018 Oct 23. doi:10.3389/fendo.2018.00613

Breakthrough, which chronicles Elizabeth Hughes, the discovery of insulin and the Making of a Medical Miracle.

We hope you appreciate this week’s rationale! Thank you so much for taking the time to answer our Question of the Week and participate in this fun learning activity!


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