Dr. Teuscher, I read your book and appreciate having a doctor like yourself articulate some of the issues which are far too often blamed on things such as patient error or something else, in spite of clinical evidence which suggests otherwise. The real issue is since Novo Nordisk's foundation ownership seems to have abandoned its original intent, it seems that the number of suppliers remaining in the world has been declining steadily, as Brazil's Biobrás S.A. was acquired by Novo Nordisk A/S in 2001.

For that reason alone, we should support efforts by Saudi Arabia to develop its own, domestic source for insulin, as well as Indian pharmaceutical companies global ambitions.

I suspect, (and this is purely conjecture), that the reason that the rDNA produced insulins are causing a reduced awareness of hypoglycemia is that they are more effective, and the patients that switched from less effective insulins are having more episodes of hypoglycemia, leading to decreased awareness of symptoms. I can't imagine any scenario involving the insulin molecule directly affecting the awareness of hypoglycemia.

Still, it's better to have more choices, particularly less expensive, non-patented choices.

Brad (an analytical chemist and Humalog pumper)

Brad,

The clinical evidence strongly suggests that rDNA produced insulins are NOT more effective than refined animal sourced insulin, and may in fact, increase the inflammation that causes the autoimmune destruction of the beta cells in type 1 patients the first place, thus causing more harm than help.

No fewer than five major meta-analysis conducted over the past 8 years, which collectively reviewed several hundred clinical studies undertaken on a worldwide basis have all reached the same conclusion: there is absolutely no clinical benefit to synthetic insulin, and it is not more effective.

I would add that a study actually confirmed the opposite, namely that type 1 diabetes begins when the body's immune system reacts to the hormone human insulin. The study was published in the May 12, 2005 issue of the British science journal Nature, and raises questions as to whether any form of "human" insulin is better for these patients, since it causes inflammation that not only destroyed the pancreatic beta cells, but causes ongoing damage that may also be responsible for some complications.

Scott
(a type 1 who is a former insulin pump user whose basal rates were so low my basal rates could not be reduced enough (zero will cause issues with losing the prime in the tubing, and therefore returned to MDI and better glycemic control as a result).

I liked the article- it's always good to have other options.

Scott, can you cite the edition of Nature magazine you referenced above?

Thanks, Colleen

This is the best and yet heart wrenching info I have had in years ! I have had diabetes for 34yrs with all of them being insulin dependent. I was testing urine with the drops of urin and the pill. While I am gratefull for the advances in the treatment of this I have no faith in the healthcare that moves forward based SOLELY on money. Not for a minute would I believe the crap healthcare providers and some doctors or healthcare institutions would put forth. They said that reincumbunt DNA would eventually be cheaper for diabetes care and 10 years later after talking to a rep for Lilly his answer was that some of our people would like raises. I am not kidding, I talked to him myself!!. The healthcare system in this country is based on profits far more than care. That's a fact. I am not a Michael Moore fan but the movie "SICKO" is an accurate account of whats going on in this,,The Greatest Country".

Sorry but I need to continue. We buried my wonderful sister in 1995 and a big reason for that was that her insuance provider made it unbelievably hard with denials for a pancreas only transplant. You have to be so close to death that your chances for a fruitful life are almost nonexistant. It was terrifing for me to sit in her room and see my what lies for me ahead. She never came home and was a wonderful 37yr old. I have said all this to say that I remember changing from pork to dna insulin and within a couple of years I had lost my insulin reaction warning signs ( sweating,tingleing and shakey)It has almost cost not only my life but the lives of others. What I read hear was the first I have heard of this difference in the insulins and what can happen. It was like the lights went on for the first time in alot of years. I have been married for 25 yrs and have 3 grown kids with 1 grandchild. I am a productive member of society and still can't afford the continual care that I have needed my whole life to avoid complications that if I don't pay for the general public will. An I V with just glucose after my wife drove me to the emergency room ( total time 1 hr )was 3,500. That is criminal!!