Insulin then and now: 100 years in the making

Blog Posts  |  30 November 2020  |  By Tom Pasquariello, PharmD, BCPS, BCMAS, PMSP, PRS

Every November, we celebrate National Diabetes Month, to bring attention to this highly prevalent chronic illness. With this year’s observance, we approach the 100th year anniversary of the discovery of insulin in 2021.1 Today, as it was in 1921, insulin continues to be a life-saving medical therapy to help people manage their diabetes and prevent the serious consequences of uncontrolled diabetes like heart disease and kidney failure, and blindness.2,3

In 1922, less than a year after being discovered, the first type of insulin was used to treat diabetes. It is important to understand the progression and advancements of insulins composition to fully comprehend how far it has come in the past 100 years. The developmental landscape of insulin has dramatically evolved to focus on improved safety, efficiency, and portability.4

Scientists, chemists, and clinicians started with a poorly defined process, isolating insulin from purified concentrated pancreatic animal (beef and pork) extracts. Early extracts of insulin took 24 hours to lower blood sugar to near normal level.5 After this work, the next step was to manipulate the hormone to maintain constant low basal levels of insulin delivery or address sudden spikes in blood glucose after meal consumption. In 1982, research led to the replacement of animal extracts with laboratory-engineered recombinant human insulin.4

Today, modified analogs make insulin more efficient and there are several types of insulin on the market to help diabetic patients with their individual needs. These include rapid-acting, regular or short-acting, intermediate-acting, long-acting, and ultra-long-acting insulin. Each has a different onset, peak, and duration of times ranging from 15 minutes all the way to 36 plus hours. Insulin also comes in varying concentrations for patients that have more severe fluctuations in their blood sugar levels, allowing for more insulin with lower volume, fewer injections, and less pain at injection site.6 With a good understanding of the biochemical properties and how the hormone is metabolized by the body, clinicians provide their patients with better outcomes.4

In addition to the structural properties of insulin, the delivery technology has also made significant advancements over the years. Beyond the basic use of multi-dose vials and syringes, there is now wide availability of insulin pens and cartridges (disposable or reusable). These additional delivery methods are increasingly important for patients to minimize potential safety issues with drawing up an incorrect dose of insulin, unintentional finger sticks, and vial contamination. Pens and cartridges help provide patients with easier and more efficient preparation and administration, more accurate dosing, and increased portability for those that needing to take insulin to work, school, sporting events, etc.4

To help patients and prescribers with the ever-growing list of FDA-approved insulin products, Veradigm™ offers a prescription price transparency solution to meet patients’ needs. Whether for insulin or non-insulin diabetic medications, Veradigm™ RxTruePrice delivers patient-specific data on discounted pharmacy benefit pricing, therapeutic alternatives and competitive prices at local pharmacies directly into each prescriber’s clinical workflow.

The brilliant discovery of insulin has helped diabetes become a more manageable disease over the past 100 years. Organizations, like Veradigm, continue to deliver technology to further improve the prescribing process to effectively and efficiently identify insulin and other therapeutics to improve diabetes for patients.


References:

  1. https://www.medscape.com/viewarticle/937919

  2. https://www.medicalnewstoday.com/articles/317484

  3. https://www.mayoclinic.org/diseases-conditions/hyperglycemia/symptoms-causes/syc-20373631

  4. https://academic.oup.com/edrv/article/41/5/733/5836295

  5. https://www.diabetes.org/blog/history-wonderful-thing-we-call-insulin

  6. https://www.diabetes.org/diabetes/medication-management/insulin-other-injectables/insulin-basics#:~:text=Intermediate-acting%20insulin%20generally%20reaches%20the%20bloodstream%20about%20two,to%20lower%20glucose%20levels%20up%20to%2024%20hours

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value-based healthcare   Diabetes   Veradigm RxTruePrice  

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