Imagine taking insulin was as easy as applying skin cream. Guess what - it's not so far fetched an idea, thanks to Phosphagenics and it may be coming soon!

Phosphagenics' has patented a transdermal carrier technology (TPM) that rapidly transports insulin across the skin without disrupting or damaging its surface. The company has recently announced successful results from clinical trials in Australia. This confirmes the TPM technology is safe and effective at delivering insulin into the bloodstream, without adverse events. The trial showed that the insulin safely penetrated through the human skin and delivered insulin into the bloodstream over a sustained period of time. Could this be the next generation of basal insulin? Adios Lantus. Arrivederci Levemir! Almost -- TPM/Insulin, applied topically, delivered insulin through the skin and into the bloodstream for up to 8 hours. So like sunblock -- you'll probably have to reapply.

Weep not, fellow Americans. Although Phosphagenics is based in Australia, they are in the process of applying for Phase 2 clinical trials in the U.S. Big ups to the Muffin Man for keeping me abreast of his leading-edge news from the diabetes-friendly forefront!

A little over 2 weeks ago I posted something about diabulemia on site where diabetics exchange their feelings, frustrations, and experiences with the disease. Two Type 1 diabetic women took the time to write me a very thoughtful hate mail. Hate is a strong word but these are some strong accusations. For starters, they said, "There ain't no such word as diabulemia. It's called diabetic stupidity." That is cut directly from the email, and as you can see - it was written with an arrogant disregard for the 450,000 people suffering from this serious condition.

I understand strong words come from passion. An email with the subject title "There's type 1, and then there are fools with type 1" could only have been composed with hateful passion. Within the passionate lines of this email were statements like "Insulin shock therapy was used in mental institutions (where you belong)." Not exactly nice words to come from a teacher - but again, the words were incensed with passion. Good, bad or ugly - feedback is terribly important to me because it conveys what matters to you. Knowing is half the battle.

By logging my experiences with diabetes on the web, these hate mailers refer to me as "You fool" for exercising my Freedom of Speech (First Amendment). To this I add -- thank goodness for the Freedom of Information Act. If I'm a Fool for sharing my experience with overcoming diabulemia and trying to lend consoling advice to others struggling with it - I'm a damn proud Fool! Hate on, haters!

There is still no evidence to declare superiority of rapid-acting insulin analogues in the treatment of type 1 diabetes. These studies compared either insulin aspart (NovoLog) or insulin lispro (Humalog) with human insulin; no such study was available for glulisine (Apidra).

Based on average HbA1c values, patients treated with NovoLog had lower levels. However, statistical comparisons were so small that an effect on patients' health is not to be expected. It was also hypothesized that Humalog may prevent night time lows better than Apidra.

Even though patients have been treated with insulin analogues for 10 years, it is still unclear as to how these types of insulin affect long-term complications of type 1 diabetes. The long-term effects of insulin decisively increase the risk of heart disease and cancer, according to recent studies at Howard Hughs Medical Institute. Would you be surprised to learn that one of the insulin analogue manufacturers chose to withhold some of the results of their studies?

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!

In light of Novo's Meet the Face of Change campaign, I figured I'd address an idea worthy of mention coming out of the Novo product pipeline. This treatment is for Type 2 diabetics but it is not insulin - it's called liraglutide. Liraglutide is a once-daily human analog of the natural hormone Glucagon-Like Peptide-1 (GLP-1). It causes neither excessive hypoglycemia nor weight gain.

Liraglutide works by stimulating the release of insulin only when glucose levels become too high. Unlike many other diabetes drugs - liraglutide also leads to weight loss instead of weight gain. Now we're getting somewhere, Novo!! Patients with Type 2 diabetes treated with liraglutide had a greater reduction in average blood sugar than those patients treated with placebo or insulin glargine (Lantus). As expected, the combination of a GLP-1 analog with a sulfonylurea caused some of the patients to experience hypoglycemia. Okay, point taken. So why impose a glucose lowering drug while mitigating the problem causing elevated sugar in the first place? One drug at a time, folks.

So this is a step in the right direction and I like where it is going. Treating Type 2 diabetes with insulin is counter-intuitive. Looking at another hormone that might interfere with the use of insulin might be the culprit. So here lies a very good idea and I like it. Gold star, Novo! Now when can we meet the face of liraglutide?

Earlier today I posted a blog on the introduction of the long-acting insulin drug Levemir to the US market. A reader has since raised the excellent question of how Levemir differs from Lantus, another long-acting insulin drug already available in the US. I went online looking for an answer to this question and found an old article from the Copenhagen Post published back in 2004. Although it's old news (excuse the pun!) by now, it is interesting because it discusses the fierce competition for dominance of the European market by the manufacturers of the two drugs: the French-German company Sanofi-Aventis (Lantus) and Danish insulin producer Novo Nordis (Levemir). Lantus and Levemir are both long-acting insulin products, right? Well, the main difference between them seems to be that Lantus only has to be injected once a day, compared with once or twice a day for Levemir. On the other hand, Levemir is less likely to cause weight gain. So it comes down to convenience versus weight control, at least according to this article. Interestingly, the market analyst quoted here basically concludes that Lantus has the competitive edge for its convenience. I would be willing to bet this logic will not apply in the US market: let's not underestimate the importance many American diabetics attach to avoiding (additional) weight gain.

News flash: drug manufacturer Novo Nordisk, Inc., announced today that a long-acting insulin product named Levemir will now be available in the United States. Levemir controls glucose levels for periods up to twenty-four hours, so only needs to be used once or twice a day. It has also proved less likely to cause weight gain and hypoglycemia in diabetics. Levemir has been approved for use in Type 1 diabetics (adults and children) and Type 2 diabetics (adults only). This drug is one of a slew of new products aimed at treating diabetes more effectively, but also in a way that is easier or more convenient - thereby addressing the worrisome fact that a great many diabetics have been diagnosed but struggle to properly manage the disease. Check out the product's press release at the website www.marketwire.com.