The CafePharma message boards are for pharmaceutical sales professionals and those interested in the pharmaceutical industry. A former Lilly sales rep started a thread about Eli Lilly and the lies they've told over the years. Pro Lilly responses flooded in, as did the anti-Lilly responses. Yesterday, however, two comments seemed to hit the message board with a vengeance.

Comments #23 and #24 epitomize the anatomy of a good old fashioned debate. Comment #23 is an Eli Lilly sales rep who claims to have helped with the successful launch of rDNA insulin, and the conversion of patients on pig and cow insulin to Humulin. He remarked from the perspective of a salesman that it was a successful venture resulting in unilateral domination. In response to his yesteryear achievement - commenter #24 raised some wonderful counter-points for modern day consideration. The following paragraph summarizes the results 25 years after the market saturation of Humulin and genetically modified human insulin.

The adverse events include: (1) Complications of diabetes are increasing. (2) Dead-in-bed syndrome is up over 300%. (3) Traffic accidents caused by people using rDNA insulins are increasing (especially in Type 2). (4) rDNA insulins are producing immunogenic responses in the same manner and numbers in the diabetic population as did pig and cow insulins. (5) No long-term studies have ever been conducted to define the dangers of the synthetic insulin hormones relative to cancer and other diseases.

Of course my favorite point is the fact that recent studies have shown that the culprit in many Type 1 diabetics may actually be the human insulin antibody produced by the diabetic. This may be self-serving beyond Type 1 diabetics needing insulin - it's giving Type 2s the very same problem.

As Bev just pointed out, diabulimia is a serious condition when a type 1 diabetic is not taking their insulin in order to lose weight. Diabulimia is a term that has only cropped up in recent years. Most people who experience diabulemia are stuck between two fears: taking increasing doses of insulin, which leads to weight gain, and the damage the destructive behavior is causing their body in the long-term.

One expert who has studied the phenomenon estimates that 450,000 type 1 diabetic women in the United States - one-third of the total - have skipped or shortchanged their insulin to lose weight and are risking a coma and an early death. Ann Goebel-Fabbri, a clinical psychologist at the Joslin Diabetes Center in Boston says, "People who do this behavior wind up with severe diabetic complications much earlier". Is that supposed to be a warning or a promise? It sounds like she's saying complications are inevitable - but if you're contented with the weight gain - you'll deter the early arrival of complications. Poor advice, doc.

The caution of do as you're told and complications will arrive later is not a very promising guarantee. The behaviors of tight diabetes control are almost tantamount to cultivating eating disorders. Studies show that women with type 1 diabetes are twice as likely to develop an eating disorder. After all -- good diabetes management requires a preoccupation with food, counting carbohydrates and following a diet. Sounds like the ingredients for an eating disorder - throw in a hormonal imbalance (genetically modified insulin that arrives late to the brain, unlike natural vertebrate pork and cow insulin) and you've got yourself diabulemia. Thanks again, Big Pharma!! Where is the prize in good diabetes management if you are punished with weight gain?