One hundred years of Nobel Prize and Diabetes

The Nobel Prize is 100 years old. The Nobel Foundation has announced the Centennial celebrations, which will be held in Stockholm and Oslo. All Nobel laureates still alive have been invited to the Centennial celebrations which will begin in the first week of December 2001 and will culminate on 10 December when the year 2001 laureates receive their prizes followed by the banquet. More than 225 laureates still alive have accepted the invitation to participate in the celebrations. The first Nobel awards were announced in 1901 in Christiania (now called Oslo) and the award function was held in Stockholm at the Royal Academy of Music (1).

Several activities are planned as part of the festival. Their Majesties the King and Queen of Sweden inaugurated a Nobel Centennial exhibition on 1 April 2001 at the Old Stockholm stock exchange. This will remain as a permanent exhibition. A copy of the centennial exhibition will be inaugurated on 9 August in Oslo and will be exhibited in various parts of the world as a touring exhibition beginning in Tokyo in March 2002.

The Royal Swedish Academy of Sciences (which selects the laureates in Physics, Chemistry and Economics)and Karolinska Institute (which selects the laureates for Medicine and Physiology) will organize essay contests for Swedish Upper secondary schools. The prizewinners will have the opportunity to attend the 2001 award function and the banquet on 10 December. Swedish and Norwegian Universities will host symposia, lectures and discussions with visiting Nobel laureates between 4 and 8 December 2001. The celebrations during the Centennial week in Stockholm include the Nobel Centennial concert on 8 December at the Stockholm concert Hall, the Nobel Foundation reception on 9 December at Nordic Museum, and the Nobel Prize award ceremony on 10 December at the Stockholm Concert Hall followed by a Banquet at the City Hall. Sweden Post Stamps and United States Postal service will jointly issue four Nobel stamps to commemorate the 100th anniversary of the Nobel Prize. In addition Sweden Post will issue two stamps with peace prize motifs and the Norwegian Post seven stamps. Royal Mail in Great Britain will also issue Nobel Centennial stamps.

In Oslo, there will be a Centennial Exhibition at the Norwegian Folk Museum and an issue of eight Nobel Peace Prize stamps and two Nobel coins, one in gold and one in silver. More than 30 Peace Prize laureates will attend the Peace Prize symposium.

In the context of the Centennial, let us remember the awards connected with diabetes. The most 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 née Radnitz Cori (1896-1957) and Dr. Bernardo Alberto Houssay (1887-1971) for their discovery of the course of the 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. The choice of Dr. Banting and Dr. Macleod for the prize has been much debated, as there was no recognition given to Dr. Charles Best. To explain this we should go back a few years to 1920 when the Danish scientist Dr. Schack August Steenberg Krogh (1874-1949) won the Nobel Prize for Medicine and Physiology for his discovery of the 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 traveled to the United States. 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 himself with the discovery of insulin Dr. Krogh returned to Denmark in December 1922 with the license to manufacture insulin. Within 3 months, the first patient was treated with insulin. 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 breast cancer.

Dr. August Krogh in his letter to his friend Dr. Göran Liljestrand who was secretary of the Nobel committee during 1918-1960 of the Royal Swedish Academy of Sciences mentions the following - "As you understand from my discourse it is my opinion that the discovery of insulin is of extraordinary both of theoretical and practical importance 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 personally have 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" (2).

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 consideration of the prize. It is customary with the Nobel committee that only nominated candidate is considered for the prize. Even though Dr. Banting shared his money from the Nobel Prize, it can never be considered the same as being awarded.

Prof. John Sjöqvist and Prof. Hans Christian Jacobaeus of the Karolinska Institute provided written evaluations of Banting's and Macleod's contributions to the Nobel committee. Prof. Sjöqvist 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" (2).

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 had seen the works of Banting and Macleod 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 been awarded 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 (3).

In fact, James Collip and Charles Best were nominated for the Nobel Prize in the years 1928 and 1950 respectively, von Mering was nominated in 1902 and 1906, Minkowski was nominated in 1902, 1906, 1912, 1914 as well as in 1924 and 1925. None of these individuals was nominated for the prize in 1923 when Banting and Macleod were nominated. Interestingly, Paulescu was never nominated for the prize at all. Had the Nobel committee waited for some more years before giving the prize for the discovery of insulin, one of these scientists would have received the prize too. Again in the history of the Nobel Prize, more than three persons never shared the prize (2).

On December 10, 1923 Prof. J. Sjökvist of the Karolinska Institute gave the presentation speech during the Nobel Prize award ceremony (4). 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 8 December at the Karolinska Institute and this did not happen in 1923, as both Banting and Macleod did not come!

I would like to thank sincerely Prof. Jan Lindsten for his help and discussions regarding this article.

References:

  1. Press release of the Nobel Foundation dated February 2, 2001. www.nobel.se
  2. Lindsten, J: Schack August Stenberg Krogh - a versatile genius. Nobel e-Museum, 2001.
  3. Luft, R, Läkartidningen 1971, 68, 4997-5004.
  4. http://www.nobel.se/medicine/laureates/1923/press.html

C.B. Sanjeevi
Karolinska Institute
Molecular Immunogenetics Group
Department of Molecular Medicine
Karolinska Hospital, CMM, L8:03
S-171 76 Stockholm
Sweden

Tel: +46-8- 517 76254 (Work)
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e-mail: sanjeevi.carani@molmed.ki.se