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January 20, 1984

Protamine Insulin: Hagedorn's Pioneering Contribution to Drug Delivery in the Management of Diabetes

Author Affiliations

From the Department of Medicine, Yale University School of Medicine, New Haven, Conn.

JAMA. 1984;251(3):393-396. doi:10.1001/jama.1984.03340270071031

The epoch-making discovery of insulin by Banting and Best led to an appropriate euphoria among physicians treating diabetic patients. Death due to diabetic coma (diabetic ketoacidosis) was largely eliminated. Life expectancy in the child with newly discovered diabetes was increased from two years to 30 years or more, and severely restrictive dietary regimens that bordered on starvation were no longer necessary for the prolongation of the life of the diabetic.1 Nevertheless, within a few years of the inception of insulin treatment, the limitations in its clinical effectiveness became increasingly apparent.

Improvements in the extraction and commercial preparation of insulin eliminated the impurities that often resulted in localized burning sensations, irritations, and even sterile abscesses at the site of injection. However, as the purity of the preparations increased, the duration of action of the injected hormone decreased.2 As a consequence, an increasing number of patients required multiple injections through