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!

Endocrinologist William Petit Jr. and his family were the victims of an utterly shocking crime on Monday. Two men entered the family home in Cheshire, Connecticut, assaulted the family and forced a woman, probably Petit's wife, to drive to an ATM and withdraw money. The burglars later set fire to the house and fled, leaving the family still inside. Dr. Petit survived the ordeal. His wife and two daughters were killed.

Dr. Petit (50) is a prominent diabetes researcher. He is medical director at the Hospital of Central Connecticut in New Britain. The hospital is a Joslin Diabetes Center Affiliate institution. Dr. Petit is also president of the Hartford County Medical Association. He was elected to the American Diabetes Association's Hall of Merit in 1994.

The two men suspected of committing this terrible act were arrested as they left the scene, and they were arraigned Tuesday. Both men have extensive criminal records. The attack has sent the small community of Cheshire (just north of New Haven) reeling. Read more in this report from Forbes. Even those opposed to the death penalty may wish that an exception be made for these two. They have committed a crime that can only be described as monstrous.

A major player in the world of diabetes management, Medtronic Inc., has just released a new product: CareLink Pro Software. The product is part of Medtronic's CareLink line for diabetes management. Designed for use by physicians, CareLink Pro Software is intended to help docs - specifically, endocrinologists - with what seems to be an increasingly impossible task: juggling all the information on diabetic patients without dropping any balls - that is, without losing anything, without making mistakes, and just generally making it more likely patients will get optimal care. So, your doctor can store and retrieve patient info from the Internet, and can store data from a patient's continuous glucose monitoring device, among other things. All this info is located in one place so docs can quickly scan through and assess each patient's state of health. Says Chris O'Connell, president of Medtronic's diabetes division, "Due to large patient case loads, many endocrinologists are often overburdened and have less time to spend with each patient, so we believe that better information and closer communication between physician and patient will help improve diabetes management and therapy outcomes."

On the one hand, it makes so much sense that this kind of technology would, as Medtronic claims, optimize patient care. And as diagnosis and treatment becomes ever more complex, data management will need to evolve and become more sophisticated and, as in this case, better tailored for specific uses. On the other hand, however, how are most medical professionals going to find the time to set it up and learn how to use it? I have to wonder how doctors greet these kinds of new technology releases. "Oh great, more gadgets to eat up my time."

For those of you following the Avandia story in the news, you're probably wondering how the patients currently taking Avandia are feeling. Are they flushing the pills down the toilet? What about the patients enrolled in GlaxoSmithKline's current Avandia clinical trial -- are they dropping out like flies? If you are unfamiliar with the Avandia debate, news broke last week that Avandia, a popular diabetes drug, may increase the risk of heart attack. A 43% higher risk.

It may depend on the specialty of your doctor. BusinessWeek has reported endocrinologists tend to be more skeptical of the study, noting its weaknesses compared to original, more rigorous clinical trials. Many cardiologists and drug safety experts give the study more weight, and remain worried about Avandia's potential cardiac danger. Doctors on the frontline are concerned patients may stop taking the drug without medical consultation as many are confused and frightened.

Dr. Nissen, the whistle-blower on Avandia and leader of the fight to withdraw Merck's arthritis drug Vioxx due to safety issues, acknowledges there are real limitations in his analysis, but he points out Glaxo's own data found a 30% increase in the risk of heart attack from Avandia. Nissen was alarmed enough to release his meta-analysis showing a 43% increased risk versus waiting for the results of Glaxo's 4,400-patient, eight-year clinical trial named RECORD, which is specifically measuring cardiovascular outcomes of Avandia.

Critics say Nissen went too far out on a limb this time as a meta-analysis examining 42 Avandia trials with varying research methodologies is not terribly reliable.

According to the Philadelphia Inquirer, the number of endocrinologists is shrinking nationally. Worse, it is doing so at the worst possible moment: as demand for endocrinology specialists soars in conjunction with skyrocketing rates of diabetes and other diseases that endocrinologists are trained to treat, namely obesity and osteoporosis. Apparently, older doctors are retiring and not being replaced by younger ones. The lack of interest in endocrinology as a specialty is being blamed in part on the fact that it pays less than other specialties yet, like them, requires a good deal of skill on the job.

The Inquirer's article on this crisis focuses, naturally, on the Philadelphia area. It quotes a local gentleman with diabetes who was told he could expect an eight-month wait to see an endocrinologist and three months to see a nurse practitioner. Not what you want to hear when you have big-time health concerns. Meanwhile, a 2005 study showed the vacancy rate for endocrinologists stands at twenty-two percent for Pennsylvania, a rate that is higher than that for any other specialty. In the case of Philly, says Arthur Chernoff of the city's Albert Einstein Medical Center and the Gutman Diabetes Institute, "There are lots of diabetics in the city and very few of me to take care of them."

Nationwide, the vacancy rate is twelve percent. All this is particularly worrying given the steady growth of diabetes across the US. The obvious question being asked by health professionals is: who will provide treatment to all these people? The answer is simple: GPs, for now at least. And while general practitioners are trained to treat diabetes, optimal care is difficult to attain without at least some degree of specialist care. One reason for this: the range of medications and other treatment options for diabetes has ballooned in past years. Specialists are more likely than GPs to have a really good handle on all of these options. An eight-month wait to see a specialist? That's not good enough.