Thea Cooper

Medical discovery is a fascinating topic for me so when I came across this book, I had to pick it up to read. Based on extensive research and facts, Breakthrough brings to life the story of the discovery and development of insulin as a treatment for diabetes. Prior to then, the only treatment available to diabetics, if you can call it a treatment, was to place them on a strict dietary regime. A dietary regime so strict - some ingesting only 400 calories of food a day - it only slightly prolonged a patient's life for an additional couple of years.

The story goes into great detail to present the scientific challenges faced during the intense 3 year period from Banting's 'middle of the night' inspiration in 1920 to the first wave of human patients in 1922-1923. The story captures fits of scientific jealousy, academic red-tape and political maneuvering that makes one wonder in amazement that they were able to accomplish what they did in such a short period of time, and with such limited financial resources in comparison to the huge timelines (14 years from discovery to market) and the dollars invested in drug development today. It also explores the moral dilemma of 'who' to treat when demand far exceeds supply, as well as how treatment was to be distributed. Not an easy decision even today.

While the story could have been just about the discovery of insulin, I felt that it made for more interesting reading with the focus that was also placed on young Elizabeth Hughes, daughter of the then United States Secretary of State Charles Evans Hughes, As such, the story provides some interesting glimpses into U.S. politics and international relations from World War I through to the mid-1920's.

One thing I do wish the book had focused on in more detail was the manufacturing and development problems faced by the University of Toronto's Connaught Laboratories and the American pharmaceutical company Eli Lilly to scale up production of insulin, how they addressed the issues of reduced potency during mass production, and the problems of determining dosage from patient to patient and insulin batch to insulin batch. The story touches on this but leaves the focus on the characters.

Overall, a great story about the discovery of insulin that I recommend to anyone with an interest in medical discoveries in general or in diabetes in particular.… (altro)