How did we allow insulin to evolve into a genetically modified hormone?

It all boils down to propaganda. If you're confident your current insulin surpasses former natural insulin in: purity, availability, allergy response, similarity and safety - I encourage you to review the following facts that were conveniently neglected or not available, due to restraints of time travel.

Purity: In the 1970s, a Genentech scientist stated that natural insulin was incredibly pure. In the 1980s, rDNA humulin insulins were less pure than the natural insulins of the 70s. The advertising campaign for rDNA insulin suggested otherwise. Here's a quote, as printed in the book, Invisible Frontiers: "They impressed upon us very, very clearly that this (human insulin) was going to be no advantage at all."

Supply and demand: A USDA scientist told the world the diabetic population's insulin needs would outstrip the supply of natural pancreatic glands. This was sensational propaganda. Have you visited McDonald's or Wendy's lately? There doesn't seem to be a shortage of Big Mac's, does there?

Allergy response: About 5-10% of the diabetic population is allergic to natural analog insulins. Today, based on 25 years of human diabetic experimentation, the diabetic population is showing the same 5-10% allergic response to all the new products. Maybe that aforementioned 5-10% is the same latter 5-10%? From the looks of it - they're just allergic to insulin, rDNA, GM or natural.

Similarity to own insulin: rDNA human insulin is just like the body makes. Who wouldn't want to take human insulin? That's the propaganda. A recent research article found in a large portion of the diabetic population, their own human insulin may actually be the cause of their diabetes. Something tells me the study included the same 5-10% of diabetics mentioned in the allergy response paragraph.

Safety: Drug companies touted rDNA insulins as providing a good a warning to diabetic patients as natural analog insulins regarding low blood glucose levels. Are you kidding me? Driver and workplace accident statistics regarding diabetics indicate that the rDNA insulins do not cross the blood-brain barrier in the same manner as natural analog insulins. The part of the brain controlling endocrine response lags because it doesn't get the signal until it's too late (if it ever gets the message). The increase of diabetes-realted deaths since the introduction of rDNA insulin is remarkable! (Center for Disease Control). How safe is that?

Fact versus fiction is a scary line to smear for the sake of business. I suggest doctors, diabetes educators, and patients review the facts today and compare it to the propaganda in the 80s. There is no suppressing the truth!

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.

Story time!! Today is Bastille Day. The French National holiday commemorates the storming of the Bastille, which was a mark of the French Revolution - a revolt against absolute power.

Although I am not French - I am convinced there needs to be a revolution against absolute power of the insulin cartel. You all know them very well - Lilly, Novo and Sanofi Aventis. You've been a loyal customer, in spite of the shortcomings of their products. One example of a shortcoming is the absence of C-peptide. It is found in proinsulin and protects cells from the complications resulting from long-term diabetes. The other is the possibility that another source of insulin might be better for your treatment than synthetic human insulin. The fact the US only offers genetically modified human insulin is not fair when it comes to balance of power. Does this sound like a revolution that a feisty diabetic like me is starting?

I am not here to tickle a revolution. I'm determined to achieve it. Every diabetic deserves the right to choose their insulin. This choice should not be made for you by those who profit from the sale. I'm a type 1. I am a diabetic because my body made antibodies for human insulin. Why must I use insulin that continues creating these antibodies? I'd like to use something a little different that makes antibodies for horse or cow or PIG insulin. Can I get some pork up in here, please? It's difficult to obtain. It's as difficult as Ricky Bobby trying to say something in French. This Bastille Day Blog is a proclamation. As a prisoner of the insulin cartel - I declare that there will be a choice one day soon. Given the choice - you might opt for an insulin revolution, too. Laissez-faire!

The discovery of insulin, in 1922, was a breakthrough in the treatment of diabetes and it produced a remarkable increase in the life expectancy of diabetic patients. Animal-derived insulins have been used to treat people with diabetes since insulin was first discovered and continuously subjected to various purification technologies. In 1973, Novo produced a purer type of insulin, called monocomponent insulin. This set a new standard in purity. In 1982, Human Monocomponent was the world's first insulin preparation identical to human insulin. It was actually pig insulin, modified by enzymes, to appear identical to human insulin.

When Novo tried to introduce monocomponent insulin into the USA, Lilly fought back with 'human' Humulin insulin. Before Humulin insulin became available, insulin had been produced from animal sources, pigs and cows. It is believed by some that the animal insulin provided the diabetic with better awareness of hypos, and it is certainly true that the long-acting animal insulin such as Ultralente are longer-acting than their 'human' equivalents. The fact that both pig and cow differ from human insulin by certain amino acids (1 in pig and 3 in cow) has lead the majority of physicians to recommend 'human' insulin. 'Animal' insulin became increasingly hard to find, particularly in the USA (see This Little Piggy Left the Market).

In the late 1990s Eli Lilly developed Lispro, brand name Humalog. This was approved for prescription use in the UK and the US by 1996. This insulin has a shorter activity curve than Regular. This means it can be injected closer to the meal time, even after it. Studies have shown that it does not improve control as measured by long-term indicators (Hba1c), but that it does decrease the number of hypos. Glargine, brand name Lantus, was approved for use in the US in 2004. It has become widely touted as better than other long-acting insulins because it has a plateau effect on glucose control that lasts for approximately 24 hours. Some people find it acts a little shorter (and some doctors don't believe that's possible!) So there you have it - the short and sweet version of the history of insulin. I strongly suggest anyone who wishes to fill the spaces between the discovery in 1922 and present day to pickup The Discovery of Insulin (Michael Bliss). I welcome all comments to fill-in the pivotal details I've failed to include.