Insulin Discovery Centenary

Part of the debate – in the Scottish Parliament on 1st September 2021.

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Photo of Emma Harper Emma Harper Scottish National Party

I welcome the opportunity to bring the 100 years of insulin debate to the chamber this evening, and I thank all colleagues who have supported it.

I thank Diabetes Scotland for its briefing ahead of the debate and for the amazing work that it does to continually support people living with diabetes, particularly during the Covid pandemic. If exposed to Covid, people with diabetes are at higher risk of severe illness, hospitalisation and even death. Figures released early in the pandemic showed that 20 per cent of Covid-related deaths were of people with diabetes.

Insulin is life saving for all people who are diagnosed with type 1 diabetes. Insulin is a hormone excreted by the pancreas directly into the blood stream so that glucose can move from the blood circulation into the cells of our body. Insulin is vital for metabolism and survival. Type 1 diabetes occurs when the beta cells in the pancreas fail and the pancreas is unable to produce any insulin at all. I note for the record that I am one of those people with type 1 diabetes. My twae sisters and my mum also have type 1, but that is a whole other story.

This year, it is 100 years since the discovery of insulin, which is one of the most significant advances in the history of medicine. Insulin was discovered in April 1921. Frederick Banting, Charles Best and Scotsman John James Rickard Macleod initially isolated insulin from the pancreatic islets of dogs, then James Collip assisted with purified cattle insulin so that it could be administered to human patients with type 1.

Before 1921, it was extremely rare for people with type 1 diabetes to live for more than a year or two. In 1921, injection was the only delivery method for insulin, and that is still the case in 2021. When my wee sister Buffy was diagnosed at nine years old in 1977, my mum reused a small glass syringe and steel needles by sterilising them in boiling water. It worked, but it was not very practical. By the time I was diagnosed in 1979, plastic syringes, which were supposed to be for one-time use, were available. They caused less pain and were easier to use.

Scotland has played its part in supporting the development of technology to treat diabetes. As well as Scotsman John Macleod, my motion mentions Dr Sheila Reith, who was a consultant at the Southern General hospital in Glasgow. Her daughter had type 1, and Dr Reith had the idea for a more portable insulin cartridge, pen-like delivery device. Dr Reith worked with colleague Dr Ireland in the late 1970s, and the Penject device, as it was called then, was subsequently created. Insulin pen delivery devices have evolved and are still used today as part of multidose therapy for people with type 1 and type 2 diabetes.

One hundred years on from the discovery of insulin, where are we now? Insulin is still the safest method of reducing blood glucose levels, and things have improved significantly. Advances in technology, such as insulin pumps, closed-loop systems, which are basically an external pancreas, and digital blood glucose monitoring devices—buttons in our arms—are helping people to live better with fewer complications. As members can see on my phone’s screen, green is good for me today. My apologies for the prop, Presiding Officer.

Diabetes complications are a huge cost burden on the national health service in Scotland, but advances, such as the pumps, are so good that such complications can be reduced. In Scotland, 312,000 people have diabetes, and the rate of diabetes is 80 per cent higher in the most deprived communities. Type 2 diabetes is a health inequality issue. It is estimated that the Scottish NHS spends £1 billion on diabetes—10 per cent of its budget. Therefore, avoiding complications will benefit people with diabetes and also our NHS.

Managing type 1 diabetes is a complex issue. A 2014 Stanford University study found that people living with type 1 diabetes make an extra 180 decisions each day compared with someone who is not diabetic—that is one extra decision every five minutes while awake. Those decisions include finding out what their glucose level is now; working out how many carbs are on their plate and whether those are fast or slow carbs; whether they should eat now or wait for two hours; whether they might go hypoglycaemic when driving home; whether they should programme their pump to deliver insulin slowly or quickly; and whether they have replacement supplies in their car, at home or in their office in case the cannula pump gets pulled out. Having diabetes is not a piece of cake; it is complicated.

We have amazing support from our NHS staff. Our endocrinologists, dietitians, specialist nurses and healthcare support workers are fantastic in supporting patients, and I thank them for their work.

There is a lot in the Scottish Government’s refresh of the diabetes improvement plan, which I welcome, including continued collaboration with the third sector and stakeholders.

I bring to the minister’s attention the work of the brothers Anthony and Ian Whittington and their fixing dad, fixing families and fixing us programmes. They helped their dad to lose 5 stone in weight. He reversed his type 2 diabetes by engaging in the fixing dad social prescribing programme, which Ian and Anthony created. That worked. Perhaps fixing dad could help to inform actions to include in the diabetes refresh strategy as it evolves.

I agree with Diabetes Scotland that everyone should have free and equal access to what they need to live healthy lives. In a recent survey of more than 1,000 people living with diabetes in Scotland, one in five said that they were having difficulty getting key diabetes technology devices. I therefore welcome the fact that the diabetes plan mentions access to diabetes technology in priority 2 and the commitment to review access to diabetes technology. Can the minister provide information on the timescales for that review and when the review of the data will be available? That will no doubt help to inform future care approaches. Could guidance be produced for all Scottish health boards to ensure that all who could benefit from diabetes tech can access it free of charge? Now is the time to ensure that everyone can access what they need. I would be grateful if the minister committed to that in her closing speech.

There are many issues to address and speak about, many of which I could not cover. I look forward to hearing colleagues’ contributions on the 100-year anniversary of insulin.