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!

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!

A study published in 1991, comparing the efficacy of human synthetic insulin to porcine insulin states "there is no reason to treat all insulin-requiring diabetic subjects with human insulin except those who have developed insulin allergy".

In light of this study - how was rDNA synthetic human insulin able to monopolize the US market?

The absence of highly purified porcine insulin in the US is probably (my guess) because it's cheaper to manufacture. The saturation of the US market with rDNA synthetic human insulin seems to be treating the masses with a specialized need existing in only a few individuals. But the top line of this marketing campaign must have had a good effect on the bottom-line, too. Sales reps convinced doctors to switch their patients because it was going to become nearly impossible to continue getting animal derived insulin. The insurance companies (the guys picking up the tab) must've loved this option, too. Why wouldn't they? It's better - right?

I'm going to do a self-analysis of the stuff, based on my IAA, IA and C-peptide levels. I've been on human synthetic insulin since 1985. I've never been on highly purified porcine insulin. The IAA is my insulin autoantibodies -- the antibody attacking my islets. My IA is the insulin antibody attacking the injected insulin and my c-peptide will tell me how much insulin my body is making. After 12 weeks on the highly purified porcine insulin - I'm going to do my labs again. I'm curious to see if these levels move, at all. If my c-peptide levels rise, that's a GOOD indicator what's best for Allie Beatty.

So is the best choice for me the best choice for all? Probably not. But at least I can see for myself - even if it costs me a pretty penny to get my hands on highly purified porcine insulin. Nobody said being an experimentalist was cheap. However, never exploring my options would deeply discount the value of experience.

While patrolling the PubMed database this weekend, I came across a very interesting study that investigated the effects of new insulins on insulin and C-peptide antibodies, insulin dose, and diabetic control. Please note - this study was published in 1983. After reading -- I invite EVERYONE to let me know if it is possible to get purified pork insulin and whether or not you have been on it-- and if you have seen a difference in your diabetes control. Please?

24 diabetic patients using bovine (beef) insulin and possessing insulin antibodies underwent a study of the immunological and clinical consequences of changes in both purity and species of their insulin. The new insulin regimes tested were one of three: a) purified bovine insulin, b) highly purified porcine insulin, and c) semisythetic human insulin.

The patients underwent 3 consecutive 4-month periods on each insulin regimen. The average insulin antibody levels changed little on purified bovine (beef) insulin; actually increased on semi-synthetic human insulin but fell substantially on highly purified porcine insulin. Okay - so this means, in lay terms that the patient's insulin antibodies (the stuff killing your islets) remained relatively the same on beef insulin but became categorically HIGH on synthetic human insulin. And most importantly - to me-the highly purified porcine insulin actually DROPPED the insulin antibodies. Of course - it would cost big pharmaceutical companies more to manufacture highly purified porcine insulin.

C-peptide antibodies fell significantly and continuously throughout the study. The slower rate of fall in C-peptide antibody levels is likely to be due to the prolonged half-life of circulating exogenous proinsulin in the presence of insulin antibody. Although insulin dose remained constant the incidence of hypoglycaemic episodes did not increase and glycosylated haemoglobin levels rose significantly when patients were on porcine insulin. The deterioration in diabetic control may have been due to greater temporal mismatch between insulin needs and insulin availability with pork or human insulin than with beef insulins, and to reduced insulin antibody levels.

The use of purer insulins which more closely resemble the human form can cause a significant reduction in levels of insulin and C-peptide antibodies. These changes may not necessarily produce better diabetic control. Recent studies have shown that a depletion of C-peptide in the body results in a greater chance of microvascular complications associated with diabetes.

This study was published around the time when all of the synthetic human insulins were sweeping the Nation. I tried calling my local CVS Pharmacy on Saturday morning to see if I could get some purified porcine insulin. No such luck. Go figure. The big guys were successful at convincing the medical community and patients that no other insulin is better. Correction - no other insulin is cheaper to manufacture and that means it is better for them. And the importance of C-peptide was overlooked entirely - or was it? C-peptide prevents the complications associated with injecting insulin - but that sounds like another marketable drug. After all - synthetic human insulin doesn't have C-peptide. REAL HUMAN INSULIN does (the way it comes out of the beta cells, in natural form, it does)!!! And as long as your body is producing insulin antibodies - you NEED their synthetic insulin (conveniently -- the only kind you can buy). Best business model - customer for life!