100th anniversary of UK’s first clinical trial of insulin

In 1923, Sheffield industrialist and philanthropist Sir Stuart Goodwin became the first patient in England to be treated successfully with insulin for type 1 diabetes.

The University of Sheffield’s Medical School was chosen by the Medical Research Council to run one of the UK’s very first clinical trials of insulin in the 1920s - 100 years on, Sheffield remains at the forefront of innovative diabetes research.

Sir Stuart, born in 1886, was a Sheffield steel industrialist and one of the city’s most generous philanthropists, giving £500,000 to local and national charities - the equivalent to around £8 million today. He was head of the Neepsend Steel and Tool Corporation and was later elected Mayor of Sheffield.

At the age of 37, Sir Stuart was diagnosed with type 1 diabetes. At the time, there was no treatment for diabetes and life expectancy was just one or two years after diagnosis.

Professor Sheila Francis, from the University of Sheffield’s School of Medicine and Population Health, who is part of the new Overend-Knight Medical History Podcast which discusses the pioneering breakthrough in its first episode, said: “When Goodwin was diagnosed, diabetes was a death sentence.

“The only way to manage the disease was a starvation diet which restricted patients to 400 calories in 24 hours.

“Now 100 years on, what we know about the condition is constantly evolving, new technologies and medicines are being developed, and researchers are making important breakthroughs. People of all ages are leading full, healthy and long lives with type 1 diabetes.”

After taking part in the clinical trial of insulin in 1923, a unique joint effort between the University and the hospital in Sheffield, Sir Stuart went on to live to the age of 83. He is reported to have donated £10,000 to the Royal Infirmary after his successful treatment. When he died in 1969, more than 2,000 mourners attended Sir Stuart’s funeral in Sheffield Cathedral.

Thanks to internationally renowned clinical researchers from the University of Sheffield and Sheffield Teaching Hospitals Foundation Trust, including Professor Solomon Tesfaye and Professor Simon Heller, the city is still renowned for its diabetes research. 

Professor Tesfaye has undertaken ground-breaking research to help the understanding and treatment of diabetes. This has included pioneering work on the causes and treatment diabetic neuropathy (nerve damage caused by diabetes which can lead to amputations and intractable pain) and the development of treatments such as electrical spinal cord stimulation.

Professor Heller has played a pivotal role in helping to advance understanding and management of diabetes leading a number of ground-breaking studies focusing on the challenges of hypoglycaemia - a symptom of insulin treatment. Professor Heller led the research team which developed and trialled the DAFNE (Dose Adjustment for Normal Eating) course. DAFNE is a lifelong approach to promote effective self-management of type 1 diabetes in adults. The trial and subsequent roll-out of the five-day training programme, together with similar courses, has changed diabetes practice in the UK. 

Professor Heller has also been at the helm of new research, known as DAFNEplus. This builds on the original DAFNE programme and is seeking to assess if modified education techniques, structured follow-up support and digital strategies can improve diabetes control and behaviour on a sustained level. 

Researchers from the University of Sheffield and Sheffield Teaching Hospitals are also involved in pioneering research that is looking to understand the mechanisms in the brain that cause painful nerve damage in people with diabetes. As well as being one of the only few centres in the world to use cutting-edge magnetic resonance imaging (MRI) technology to shed new light on nerve damage in the brain, the team have also been awarded a £463,000 UK Research and Innovation (UKRI) grant to find much-needed treatments for chronic nerve pain using AI-powered MRI neuroimaging technology. Up to half of people living with diabetes end up suffering with chronic nerve pain, and a quarter of these will have pain in their feet.

Hannah Postles, 38, from Sheffield was diagnosed with type 1 diabetes aged 26.

"I was diagnosed with type one diabetes in December 2011 and, since then, have needed to inject myself with insulin up to five times every day to stay alive,” said Hannah.

"Diabetes care has progressed so much since those first clinical trials in Sheffield 100 years ago, and even in the 12 years since I was diagnosed. 

"I used to have to prick my finger to test my blood glucose, but I now wear a sensor on my arm that automatically sends my readings to my phone. I will soon be moving to an insulin pump instead of giving myself insulin injections, and my pump and sensor will communicate with each other to help keep my blood glucose levels in a healthy range. 

"It is remarkable to think that, while type one diabetes was a death sentence for patients before the discovery and first clinical trials of insulin, we are at a point 100 years later where more and more patients are able to access technology that essentially gives them an ‘artificial pancreas’.  

"These improvements make a real difference to people’s lives, reducing the burden of living with a condition that can be so difficult and exhausting to manage. As someone who receives their diabetes care in Sheffield, I feel really proud that together, the city, hospital and university played such a critical role in the first British clinical trials of insulin, and am grateful to everyone involved in the research that has taken place since then."

The University of Sheffield has a long history of innovation in medicine since its foundation of the Medical School in 1828, including the first documented use of penicillin. Sir Howard Florey, former Chair of Pathology at the University of Sheffield, conducted the first clinical trials of penicillin in 1941.

You can learn more about Sir Stuart Goodwin and the UK’s first clinical trial of insulin on the University of Sheffield’s new Overend-Knight Medical History Podcast available on University of Sheffield Player, Spotify and ApplePlay. 

Contributors to the podcast are: Allan Pacey MBE (Honorary Professor at the University of Sheffield and podcast host), Jackie Elliott (Senior Clinical Lecturer in Diabetes, The University of Sheffield), Solomon Tesfaye (Honorary Professor of Diabetic Medicine, University of Sheffield and Consultant Physician, Sheffield Teaching Hospitals NHS Foundation Trust),  Mike Collins (medical historian), Professor Sheila Francis and Andrew Tattersall (co-producers).