Elizabeth Hughes weighed a mere 45 pounds when she walked into the clinic of Frederick Banting, MD, on August 16, 1922. It was three days before her 15th birthday. Since her diagnosis with what today we call type 1 diabetes, Elizabeth had been strictly adhering to a starvation diet, the only available treatment for her condition at the time.

Type 1 diabetes is a condition in which the body’s pancreas does not produce enough insulin. Insulin is a hormone that helps move sugar from the blood stream into our cells where it can be used for energy. If sugar builds up in our blood, it can damage tissues throughout the body, especially the eyes, nerves and kidneys. Before the discovery of insulin, people with type 1 diabetes were not expected to live more than one year after diagnosis.

Elizabeth, diagnosed in 1918, had already exceeded her life expectancy three times over. She navigated the opposing dangers of death from diabetic coma or starvation through careful adherence to a very strict diet.

In the early 1900s the scientific community suspected that something produced by the pancreas could treat type 1 diabetes and multiple labs were working to isolate that elusive compound. Patients endured on diets as low as 500 calories a day or less in the hopes it would extend their lives just long enough for that discovery to be made.

Then, on December 30, 1921, at the American Physiological Society (APS) meeting in New Haven, Connecticut, Frederick Banting announced a breakthrough. He and his graduate student, Charles Best, had successfully reversed the symptoms of diabetes in dogs by administering an extract from the pancreas.

Banting and Best worked in the laboratory of then-APS president John MacLeod, PhD. After their initial results started showing success, they were joined by James Collip, MD, PhD, who helped better refine their extract. Through work with dogs and rabbits, the team refined extractions from pancreases leftover from beef production into something that was safe enough to try in humans. Banting and McLeod went on to win the 1923 Nobel Prize for the discovery of insulin.

Elizabeth was among the lucky earliest patients to begin receiving insulin injections in 1922. One hundred years later, insulin remains the primary treatment for both people and pets with type 1 diabetes. In the U.S., about 1.4 million people and an estimated one in three hundred dogs rely on insulin to stay healthy and active.

Insulin is not a cure for diabetes, but the work of Banting, Best, Collip and MacLeod changed a death sentence to a chronic condition that can be managed with care and planning.

Elizabeth Hughes went on to graduate from college, marry, raise three children, travel the world and stay active in her community. Instead of dying in 1919, as she was expected to, thanks to insulin, she lived another 59 years, until 1981.

—Claire Edwards