Diabetes, a group of conditions in which the body can’t properly regulate blood sugar, affects roughly 30 million people in the US.
And for many people living with diabetes — including the 1.25 million people in the US who have Type 1 diabetes — injecting insulin is part of the daily routine.
Insulin, a hormone that healthy bodies produce, has been used to treat diabetes for almost a century, though it’s gone through some modifications.
In the past decade, the list prices of insulin have risen about 300%. This has drawn criticism from patients having to pay the high cost as well as from political figures such as Senator Bernie Sanders, who went after insulin drugmakers this month over their exorbitant prices.
Here’s the story of how the critical diabetes medicine became what it is today.
Insulin is an integral part of the human body. It's a hormone that, in most people, is produced in the pancreas to help regulate our blood sugar levels. For those living with Type 1 diabetes, the pancreas doesn't make any insulin, which can cause blood sugar levels to rise too high after a carbohydrate-rich meal, or fall dramatically unexpectedly.
Back in the 1920s, researchers figured out that the pancreas was an important part of what was making diabetics so sick and got to work figuring out if they could make a treatment for them. Pictured here is an inflamed pancreas alongside the duodenum to its right, and the spleen to its left, in a rhesus monkey.
Dr. Frederick Banting, a Toronto-based surgeon, along with medical student Charles Best, started by testing out what happens when you remove a dog's pancreas. When they did, the dog developed diabetes. Next, they found that if you inject insulin back into the dog, it went back to normal.
From there, it wasn't long before Banting and Best began injecting insulin from animal pancreases into people to treat their diabetes. In 1922, the first person with diabetes was given an insulin injection. The team went on to win the Nobel Prize for the discovery of insulin in 1923, and later sold the patent for a total of $3 to the University of Toronto.
For a long time, these animal insulins were used to treat people with diabetes, with new modifications to help them work even better. Then, in the 1970s, scientists found that they could use recombinant DNA to manufacture real human insulin. That way, it'd be more similar to the insulin that humans without diabetes naturally produce.
Since the first analogue insulin was approved (Humalog), the list price of a vial has steadily increased in step with its competitor, Novolog. In the last decade, the price has gone up 300%.
Most people who need insulin either inject it with a syringe, a pen, or an insulin pump (pictured here) that can deliver insulin as needed throughout the day.
Research into finding newer insulins, or better ways to deliver insulin, continues. In September, the FDA approved the first 'artificial pancreas,' a device that can both monitor glucose levels and deliver insulin. And according to the drug trade group PhRMA, there are 135 drugs in development for both type 1 and type 2 diabetes.
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