I don't mind high sugars as much as I loathe lows. Personally I'm not so ruffled by shots either (but my liver begs to differ). However, in a message posted on The Islet Foundation, Pfizer reported that insulin-dependent diabetics declared they most hate taking shots. Was this the warm-up for the Exubera campaign? Here's a fact I support! A close second to this hatred is the hypos. Any diabetic will confess -- hypos are unforgiving. So what if you could catch two birds with one capsule?

I must reiterate the scientific genius behind the Oramed gel caps. The encapsulated insulin bypasses destruction in the stomach cavity. It reaches an entry point in the intestines where it reports for duty to the liver. This allows the liver to resume command of the glucose metabolism, just like Mother Nature intended. Whey you inject insulin - you are overriding the livers ability to monitor blood sugar and putting yourself in the line of fire for the dangerous lows. We all know this state of derangement too well. You won't find my lows picture on a milk carton if I happen to lose it, either.

Frequent episodes of hypoglycemia (even mild ones) force the brain to become accustomed to the low glucose. Unfortunately this also causes suppressed signaling of adrenaline, the livers last resort before dangerous lows. More specifically, the glucose transporters located in the brain cells are damaged from frequent episodes of hypoglycemia. So what was once the hypo threshold for the brain to signal adrenalin release becomes lower. Clinically, the result is hypoglycemic unawareness. Down with the shots, down with the lows and big ups with the future of diabetes control! Now we're getting somewhere.

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!

Ever heard of MedCo Health Solutions? It's not a household name like the big pharmaceutical companies Novo, Glaxo etc. However, MedCo, which happens to be in the prescription benefit management business, is a large and powerful company. Now it's about to become even larger: the company is poised to pay $1.5 billion for PolyMedica Corporation, the nation's biggest supplier of diabetes-related products.

According to a Forbes report on the deal, PolyMedica has nearly one million patients using its products. Its product line includes Liberty Healthcare brand, blood glucose test kits and meters, lancet kits, insulin and the like. The Forbes article says the move is basically a smart one on the part of MedCo: it can cash in on the growing demand(14.5 % growth, annually!) for diabetes supplies. MedCo's chief exec, David Snow, told Forbes he anticipates the purchase could make his company (indirectly) the supplier of diabetes treatment products to half of all insured Americans with diabetes.

Factoid: ads for PolyMedica star "Cocoon" and "Seinfeld" actor Wilford Brimley.

Drug War '07: drug giants Novo Nordisk and Sanofi-Aventis have been sparring recently over their insulin pen designs. Novo alleges Sanofi has stolen its design ideas, basically. Check out Bev's post on this to learn more.

The reason it's such a big deal to them is money. The insulin pen could be super-lucrative for investors. Meanwhile, here's some news that's bound to get big pharma even more excited: a new study reports that insulin pens are cheaper and more effective than insulin shots.

Why so good? Fewer trips to the emergency room and fewer visits to the doctor. Insulin pens boast a pre-measured dosing system, with each dose of insulin contained in a single, disposable cartridge. This eliminates the risk of over- or under-dosing, says senior author of the study, Dr. Rajesh Balkrishnan of Ohio State University in Columbus. The researchers say that study participants who used an insulin pen instead of a regular syringe ended up reducing their annual healthcare costs by nearly $17,000. Wow.

What I'm not clear on here is whether or not they factored in the added expense of upgrading from syringes to insulin pens.

Want to know more? The study has been published in the latest issue of Clinical Therapeutics, but you can click here to read a summary.

Shhh. Big Pharma scientists hard at work. On what, you ask? Why, on Novo's new "baby" - a drug designed to treat type 2 diabetes. Liraglutide, a hormone analogue, is supposed to improve blood sugar control. It's also supposed to get you that coveted magic bullet (a la Byetta): weight loss. Ooh, baby. Now that's medication!

Novo Nordisk has been working on Liraglutide for a while now. Here's the latest: Novo announced Monday that two Phase III studies were successful in demonstrating the aforementioned blood sugar control and weight reduction. Novo is riding high on the news: its shares rose six percent on the announcement. According to a pharmaceutical industry analyst quoted by Reuters, the shares surged so healthily because the positive news was expected.

The powers-that-be at the drug giant say they hope Liraglutide can be submitted for regulatory approval by mid-2008. They hope it will become another blockbuster, with estimated annual sales topping one billion. Stay tuned.

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!

For those diabetics injecting insulin and getting frustrating results - this blog's you. I include in this group of frustrating results: hypo unawareness, diabulemia, lethargy, weight gain, erratic blood sugars, and missed periods (for the ladies) - these are all side effects people have experienced once beginning genetically modified human insulin. It so happens it is the only kind available in the United States.

Bev did a terrific blog on the Insulin Dependent Diabetes Trust and the difference a choice has offered me: more controlled blood sugars, lower blood pressure, less hunger and even a little weight loss - high five! But herein lies the problem - the choice is not easy to come by. Most doctors believe Big Pharma pushed genetically modified human synthetic insulins because it was better. However this, like the insulin analogues - was nothing but stellar marketing with lackluster scientific proof.

If any of those symptoms listed in my first paragraph kept you reading to this point - please ask your doctor to give natural animal insulins a second chance. Do yourself and other diabetics a favor and request information to bring to your doctor by emailing enquiries@iddtinternational.org. The IDDT will send information on natural animal insulins. You may not be interested, but another diabetic may love the fact it will soon be a choice for them. Freedom of choice - isn't the Liberty Bell appropriate here?

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?

Novo Nordisk, one of the Big Three insulin manufacturers (Eli Lilly and Sanofi-Aventis round out the group), has started legal action in the United States to block the launch of rival Sanofi-Aventis' new SoloSTAR injection pen. Novo claims Sanofi's SoloSTAR infringes on the patents of its NovoPen 4. Sanofi is ramping up for a U.S. launch in the next few months -- they contest Novo's claims and will defend their rights in court.

According to a March 2007 post in Scott Strumello's blog, the SoloSTAR is a disposable insulin pen aimed at the vast type 2 market, and Sanofi's Lantus will be the first insulin used in the new pen. SoloSTAR reduces the injection force by 30 percent or more compared to other leading disposable pens, good for people with poor grip or limited hand mobility. Different pen colors will be offered for different insulins, a nice feature to aid in correct insulin identification.

From my internet and blogosphere research, the SoloSTAR was introduced in Europe last April, and it was recently approved by the Food and Drug Administration.

This isn't the first Novo/Sanofi patent scuffle. Novo has alleged Sanofi's OptiClik pen deliberately infringed patent protections on Novo's Flexpen (post image from www.novonordisk.com). The Insulin Dependent Diabetes Trust's April newsletter stated the case should go to court sometime this year.

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.

This headline on the website Diabetes Health got my attention: "The Federal Government Hugely Out-of-Pocket for Diabetes Care." Here are the key numbers: In 2005, the federal government spent almost eighty billion dollars on diabetes care, writes Linda von Wartburg, reporting on a study commissioned by drug giant Novo Nordisk as part of its "Changing Diabetes" campaign. In fact, one in every eight healthcare dollars - or twelve percent of the budget - was spent on diabetes. Need some more perspective? Well, according to the Novo study, this amounts to more than the entire budget of the Department of Education. Phew.

Yes, diabetes care is costing a lot of money. But the ballooning cost of diabetes treatment is only part of the problem. Of equal concern is the amount spent on care versus the amount allocated for prevention and education. Paltry, is the word you might use. Of the 79.7 billion spent, only 3.9 billion went to prevention or education. Considering Type 2 diabetes cases are ballooning in the US - some say it constitutes an epidemic - the feds might want to consider tweaking the budget a bit, don't you agree? That's what the study's authors are recommending. They say more money is desperately needed for prevention and public education. Click here to read more on Novo's Federal Spending Report.

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!

Eli Lilly has an award they give to people who have been diabetic for 25, 50 and 75 years. They call it the Lilly for Life Award. The award recognizes people who have been enslaved to the exorbitant expenses of diabetes management, in addition to the other schedules of daily life. Endearing isn't it? The award is a significant token of Lilly's appreciation for all you have endured and sacrificed.

Lilly awards people who have used insulin for 25 years with the monetary equivalent of what your diabetes management has cost. All your copays for each bottle of insulin, each box of syringes, each blood sugar testing strip, and your ability to adapt to the ever-changing technology of diabetes care (I swear, it says that in block letters) - Lilly awards you $42,500!! I told you I lived in the land of milk and honey. ACTUALLY - it's a medal and a consent form to have your face exploited in Big Pharma marketing. You should've bought the stock! The shareholders of LLY paid approximately $1.75 per share 25 years ago, when you were diagnosed. Today that share is worth approximately $56. Anybody know the math on that return? It's probably around 3,000%.

Let's go back to that statement ever-changing technology of diabetes care. Why must it be ever-changing? Doesn't that sound a lot like never-ending? We need not spend too much time on identifying how to treat this disease when we've got that down. What we need to do is spend more time and energy on preventing the disease from happening in the first place. That is what I consider achievement. Achieve that, Lilly! And by the way - I'll take 3,000% of my $42,500 while you're at it. Thanks.

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?

I was excited to see my friend, Lissa Coffey, appearing on The Today Show this morning. Lissa is a PhD, a relationship expert and sociologist. Lissa shares her ancient wisdom and modern style through her site, Coffey Talk, and her newsletters. A recent newsletter addressed homeopathic medicine and I share with you how this applies to the treatment of diabetes.

Homeopathic medicine is a natural pharmaceutical science developed in the early 1800s. It uses small doses of natural substances (animal, vegetable, and mineral) to stimulate the body's own defenses. Homeopathy is a word derived from the Greek words for similar and disease. It is medicine based on the law of similars that says a substance will help to heal symptoms similar to those that it is known to cause. This is the same principle behind immunization.

When I received Lissa's newsletter on homeopathic medicine immediately I thought of how this applies to diabetes - a disease of insulin antibodies attacking the naturally produced insulin in the body. Why would you treat a disease with the exact hormone that caused it? Novo, Lilly, Aventis - you are all making a grave mistake in forcing American's to use GM human insulin, both Type 1 and Type 2. The extinction of porcine and bovine insulin has consequently proven to be detrimental to diabetics over the last 25 years. Studies show tighter control - yet complications on the rise. How do you explain this? I'm not excited for what the future holds, unless we see a return of these similar but not exact insulin forms.