Nobel centennial and diabetes

THE NOBEL Prize is 100 years old. The Nobel foundation has announced the Centennial celebrations, to be held in Stockholm and Oslo, beginning from the 1st of December 2001 and culminating on 10th December when the year 2001 laureates receive their prizes.

In the context of the centennial, the awards connected with diabetes need special mention. The important one was the 1923 prize for Medicine and Physiology awarded to Dr. Frederick Grant Banting (1891-1941) and Dr. John James Richard Macleod (1876- 1935) for the discovery of insulin. The other prize was the 1947 prize to Dr.Carl Ferdinand Cori (1896-1984), Dr. Gerty Theresa nee Radnitz Cori (1896-1957) and Dr. Bernardo Alberto Houssay (1887-1971) for their discovery of course of catalytic conversion of Glycogen.

The 1923 prize to Banting and Macleod was probably the only occasion in the last 100 years of Nobel prizes, when the prize was given the year after the discovery. It is probably by providence that such a thing happened.

Choice of Dr. Banting and Dr. Macleod for the prize has been debated, as there was no recognition given to Dr. Charles Best. To explain this omission we should go back a few years earlier to 1920 when the Danish scientist 'Dr. Schack August Steenberg Krogh' (1874-1949) won the Nobel Prize for Medicine and Physiology for discovering capillary motor regulating mechanism.

Dr.SAS Krogh was considered one of Denmark's greatest biologists next only to Niels Stensen and was considered a versatile genius. He became very famous after winning the prize and of course influential. Dr.Krogh's wife Marie Krogh, who was a physician and research colleague, developed maturity onset diabetes in 1921. She was diagnosed and treated with a special diet by another physician by the name of Hans Christian Hagedorn. In 1922, Dr.Krogh and his wife travelled to U.S. for scientific reasons. While dining with the famous American diabetologist Dr. Eliot P. Joslin, Dr. Marie Krogh came to know that a research group in Toronto had isolated insulin.

This news prompted them to visit Toronto where they stayed as guests of Dr. John Macleod in November 1922. After familiarizing with the discovery of insulin Dr. Krogh returned to Denmark with the licence to manufacture insulin in December 1922. Within 3 months, a diabetic patient was treated with insulin in Denmark.

Dr. August Krogh together with Hans Christian Hagedorn established the Nordic Insulin laboratory that became the starting point of the Danish Pharmaceutical Company `Novo Nordisk'. Dr. Marie Krogh was treated with insulin until she died in 1943 from a breast cancer. Their children did not know that she had diabetes.

Dr. August in his letter to his friend Dr. Gran Liljestrand (who was secretary of the Nobel committee during 1918-1960) of the Royal Swedish Academy of Sciences mentions the following (as translated from Danish):`` As you understand from my discourse it is my opinion that the discovery of insulin is of extraordinary importance, both theoretical and practical and it will hardly surprise you that I intend to submit a nomination that the Nobel Prize be awarded to Dr. Banting and Professor Macleod".

In his nomination letter, Dr. Krogh writes,`` With the information which I have personally obtained from Toronto, and which also, although less clearly so, emerges from the published works, one may conclude that the credit for the idea behind the work which led to the discovery, undoubtedly goes to Banting, who is a young and apparently very talented man. However he would definitely not have been able to carry out the investigations, which from the start and during all stages, have been supervised by Professor Macleod." G.W. Crile of Cleveland and F.G. Benedict of Boston also nominated Dr. Banting, in addition to Dr. Krogh, for the Nobel Prize in 1923. G.N. Stuart of Cleveland also nominated Dr. Macleod, in addition to Dr. Krogh, in 1923. Charles Best was not nominated in 1923 and hence he was not included for the consideration of the prize.

It is a custom with the Nobel committee that only nominated candidates are considered for the prize. Even though Dr. Banting shared his money from the Nobel Prize with Dr.Best, it can never be considered the same as getting awarded. Prof. John Sjqvist and Prof. Hans Christian Jacobaeus of the Karolinska Institute provided written evaluations of Banting and Macleod's contributions to the Nobel committee.

Prof. Sjqvist came to the same conclusion as Dr. Krogh that the prize should be divided between Banting and Macleod. However, Prof. Jacobaeus wrote,``Dr. Banting, who undoubtedly was the first to have the idea and who has carried out the investigations, should be the one who in the first place is awarded the prize. On the other hand, it is difficult to evaluate Macleod's contribution. It is not apparent from the literature.

Macleod, who is the head of the department in Toronto, has previously carried out investigations on blood sugar. Banting came to Macleod with his idea and purified insulin under the direction of Macleod. ``I have been told that it is very likely, that the discovery would never have been made if Macleod had not guided him, at least not as early as it turned out. It has even been declared that Banting planned experiments that would not have been successful unless corrected by Macleod. On the basis of what has been said I am most inclined that Banting and Macleod jointly receive the Nobel Prize".

The influence of the nomination by Dr. Krogh on Dr. Liljestrand (who was the chairman of the Nobel committee at that time) can be assumed to be heavy as Dr. Krogh a Nobel laureate himself has seen the works of Banting and Macleod all by himself.

On speculation, the visit of Dr. Krogh to Toronto was actually prompted by his wife's diagnosis of diabetes. Had she not developed diabetes and had she not sat next to Dr. Eliot Joslin during dinner in Boston they might not have visited Toronto at all. Banting and Macleod might not have got the prize in 1923 but some years later and Charles Best would have been included in the nomination. Several others also deserved the prize for the discovery related to diabetes mellitus and they include James Collip, Nicolas C. Paulescu, Joseph von Mering and Oskar Minkowski.

In fact, James Collip and Charles Best were nominated for the Nobel Prize in the year 1928 and 1950 respectively, von Mering was nominated in 1902 and 1906, Minkowski was nominated in 1902, 1906, 1912, 1914 as well as 1924 and 1925. None of these individuals were nominated for the prize in 1923 when Banting and Macleod were nominated.

Interestingly, Paulescu was never nominated for the prize at all. Has the Nobel committee waited for some more years before giving the prize for the discovery on insulin, one of these scientists would have got the prize too.

Again in the history of the Nobel Prize, more than three persons never shared the prize. On December 10, 1923 Prof. J. Sjkvist of the Karolinska Institute gave the presentation speech during the Nobel Prize award ceremony. But both Macleod and Banting could not attend the award ceremony and the prize was handed over to the British minister by His Majesty the King to be given to the laureates. It is customary that the prizewinners give Nobel lectures on 8th of December at the Karolinska Institute and this did not happen in 1923, as both Banting and Macleod did not come! C.B.Sanjeevi

Karolinska Institute, Stockholm.

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