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?

Slow and steady wins this race -- and that is why Flamel Technologies took the more natural approach with basal insulin in developing Basulin. The results in a comparison study with Lantus showed patients, while on Basulin, experienced 50% less hypoglycemic events.

Basulin is a controlled release of human insulin, not an insulin analogue like Lantus. The goal with Basulin is to deliver human insulin in order to reduce the risk of potential immune response which can be created by artificial insulins. Lantus has been the preeminent leader since its introduction in 2000. However, Lantus is an insulin analog, meaning that its molecular structure has been changed slightly, to sustain this long-lasting effect. The long-term effects and safety of insulin analogues have not been established.

In a human study, patients formerly treated with Lantus were then changed to Basulin. On the day prior to replacement of Lantus with Basulin, 11 hypoglycemic events were experienced in the 30 patients receiving Lantus. Once these patients were switched to Basulin for the 14 day trials, an average of only 5.1 hypoglycemic events per day occurred. This result is very encouraging, because hypoglycemia is a severe and commonly observed event in T1DM patients. Here is the billion dollar question (In 2006 over 60% of $8.9 billion was spent on long-acting insulin) -- is this more natural Basulin more fat-loving (like real human insulin) in comparison to the insulin analogue Lantus?

Mad Money is a stock show on CNBC hosted by Jim Cramer - a well-known iron fist on Wall Street. He has a following of stock enthusiasts who regard his recommendations (buy or sell) as gospel. Why is he so good at what he does? He just wants to help you make money.

And to this end -- the reason I bring Cramer's passionate drive to The Diabetes Blog is simple: last week he called Novo Nordisk as a SELL. Cramer said he's beginning to worry about a backlash on drug stocks. He advised that viewers should not be greedy and should take gains in Novo Nordisk (NVO).

Perhaps the NY Times article raised some eyebrows at Big Pharma. It appears doctors are receiving handsome gifts and stipends for handing out samples of drugs that were not all that safe for most patients. The payments give physicians an incentive to prescribe the medicines at levels that might increase patients' risks of heart attacks or strokes. In light of this blood curdling synopsis Novo got a dishonorable mention. Novo Nordisk professes to operate their company in two parts: biopharmaceuticals and Diabetes Care. The Diabetes Care segment provides insulin analogues, human insulin and insulin-related products, and oral antidiabetic drugs.

The cross examination of the C-peptide disappearing act and mysterious insulin auto-antibodies appearing where they shouldn't is just getting started. Thanks for making them sweat, Cramer!

In 2005, insulin cost state Medicaid programs $500 million. The diabetes epidemic is causing the government to question one of the big-ticket items on the shopping list - insulin. Insulin was developed over 20 years ago and many of these original forms are now off patent. This is a screaming opportunity for generic drug makers to prosper and government programs to save.

Two of the largest insulin makers, Novo Nordisk and Eli Lily, say they are opposed to any F.D.A. action that would approve generic insulin without clinical studies. Why the concern? The combined sales in the United States for Humulin and Novolin is about $1 billion. No wonder.

A drug maker needs to prove the generic version contains the same active ingredients, purity and quality, and provides equivalent delivery over time as the brand-name version. However the makers of generic drugs agree that the approval process for generic biologics, like insulin, would be more complex than the current shortened process for other generic drugs. Anybody have a guess as to what the hold up is for this much needed and overdue generic insulin explosion?