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Before the introduction of insulin the management of diabetes was bleak. Diabetics had to be hospitalized for weeks on end, not much different from the treatment they received in the eighteenth century. At the beginning of the twentieth century, following experiments with pancreatectomies on dogs that then developed fatal diabetes, physiologists focused professional and public attention on the lack of an internally secreted pancreas hormone in human diabetics. Bestowing the Nobel Prize in Medicine on Canadian Frederick Banting and J.J.R. Macleod in 1923, the awards committee overlooked Best. Insulin demand worldwide rose so fast that an experienced pharmaceutical house had to step in and in May 1922 Lilly agreed to pay royalties to the University of Toronto to support research in return for manufacturing rights in North and South America.Keywords: Canadian Frederick Banting; diabetes; insulin; J.J.R. Macleod; pancreas hormone

“Diabetes is a mysterious illness.” This statement made in antiquity by the physician Aretaeus of Cappadocia (ca. 81-138 A. D.) is still valid today. For almost two millennia the real cause of this strange ailment remained obscure. Finally, when pancreatic diabetes was discovered in 1889, and when insulin became part of the pharmaceutical armoury in 1922, it was thought that the cause and the etiological therapy of diabetes had been found. At that point, the new discoveries led to a new set of problems which presented research with further challenges. There was resistance to insulin, the action of the pancreas hormone on the metabolism of carbohydrates and fats, and new insights into pathology and electron microscopy, to cite but a few. The fact that in the first century A. D. Aretaeus could say that “… (Diabetes)is not at all frequent in humans”, while in 1964, at the 5th Congress of the International Diabetes Federation in Toronto, Paul S. Entmacher and Herbert H. Marks stated that 1 in 900 healthy 25-year olds is diabetic and that this rate becomes 1 in 200 between the ages of 25 and 44, and 1 in 50 among 45 to 65-year olds, rising to 1 in 20 after the age of 65, has given much food for thought on various levels; even so, to this day the exceptional increase in cases of diabetes throughout the world cannot be explained fully.