People's History of the NHS

How insulin saved the life of Alan Nabarro and millions like him

Before the discovery of insulin in 1922, a diagnosis of type-1 diabetes was a death sentence.  Alan Nabarro (1914-1977) was one of the first people in the UK whose life was saved by the new treatment, and his personal papers, which can be accessed at the Royal College of Physicians archives, tell of his experiences as a child using insulin for the first time, and his subsequent lifelong commitment to raising awareness and improving the lives of people with diabetes.

Alan’s family was told he had diabetes in 1921 when he was 7 years old, at a time when most children did not live longer than a year after diagnosis.  For any family this would have been devastating news, but luckily for Alan, his uncle was a pathologist at Great Ormond Street Hospital and was aware of a glimmer of hope.  David Nabarro (1874-1958) had heard of potentially revolutionary research involving the hormone insulin, being conducted by Frederick Banting (1891-1941) and Charles Best (1899-1978) from the University of Toronto, Canada, with colleagues in Santa Barbara, California.  David began telegramming the researchers, and as Alan’s condition worsened, his requests for insulin became increasingly desperate.  Indeed, one of David’s telegrams (pictured above and here) seems to imply that Alan is his son rather than his nephew, perhaps because he was determined to convey the greatest possible emotional urgency.  Frustratingly, David was told that insulin was not yet ready for distribution.  Alan’s family then turned to a Dr Devos, a diabetes specialist in Brussels.  Dr Devos flew to London to see Alan and another diabetic boy, Neville Janion.  Dr Devos put Alan on a near-starvation diet of spinach and cream once a week, until finally in 1923 he was able to get regular insulin supplies.  Today, insulin and equipment such as injection pens are available free from the NHS for anyone diagnosed with type-1 diabetes, with a medical exemption certificate.

Like all people with type-1 diabetes, Alan had to learn how to adapt his lifestyle for living with the condition.  From an early age he took an active interest in managing his own condition, including regulating his sugar intake.  Among his papers are several diet sheets that he produced as a child, detailing what he could eat each day, and in what quantities, including a special Bar Mitzvah diet sheet (MS5939_2).  A major impact on Alan’s life was the need to inject himself with insulin twice every day.  One of his letters describes a frightening incident that occurred when Alan was 11, and was verbally abused by a stranger in a restaurant toilet while injecting himself with insulin.  Alan told his consultant, Geoffrey Harrison, about this, and Dr Harrison gave Alan a certificate to carry with him at all times to explain his condition and his requirement for insulin treatment.  In some ways, this was a personalised precursor to the insulin passports, developed by NHS Diabetes, that some patients carry in case of emergency.  These cards include details of the patient’s treatment and are intended to inform people of what to do if they are found ill or unconscious.

When he was 21, Alan joined the British Diabetic Association (now Diabetes UK), and spent the rest of his life promoting awareness of diabetes, writing articles and speaking at conferences around the world [MS5943_6].  He remained friends with Dr Harrison throughout his life, and his campaigning work led to his forming friendships with several prominent figures, including Charley Best, one of the original discovers of insulin.  When Alan met and fell in love with Vera Kadish, Alan’s mother wrote to three specialists asking whether there was any reason why his condition should prevent him from marrying.  The doctors all replied in the negative; Alan and Vera were married in 1944, and went on to have two children.

By the 1970s, Alan was one of the longest living people with diabetes up to that time.   After his death, the British Diabetic Association decided to honour his memory with the inauguration of the Alan Nabarro Medal, which is still awarded today to people who have lived with diabetes for 50 years or more.

-Felix Lancashire, Assistant Archivist, Royal College of Physicians