The incredible history of insulin, a drug that was discovered almost a century ago
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.
Source: NobelPrize.org, Clinical Chemistry
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.
These human insulins (also known as regular insulin) are still in use, although starting in the 1990s, a third wave of insulin came on the scene. These analogue insulins built on the human insulins, but had slight variations that make them act more like the insulin naturally produced and regulated by the body.
A 2011 World Health Organization review, however, did not find that analogue insulins had any advantage over human insulins. The newer insulins also come at about twice the price as human insulins, which the WHO said was not worth it.
Source: World Health Organization
Since the first analog 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.
Over the years, researchers have also tried to bring inhaled insulin onto the market. Most attempts have failed, but one called Afrezza is currently available.
Source: PubMed
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.
Sources: Business Insider, PhRMA
Even so, the current price of insulin continues to be a concern for those living with diabetes along with their families. It's attracted the attention of lawmakers like Senator Bernie Sanders, who went after insulin makers in early November.
Source: Business Insider, Business Insider
The main reason why insulin prices have gotten so high is that there aren't generic versions. Unlike chemically-derived drugs like statins which are designed to lower cholesterol, or pain medications like ibuprofen, insulin is made of living cells. But one kind, which was approved this year called Basaglar (technically called a "follow on,"), is set to launch in the US in December 2016 at what will likely be a discounted price to its competitor, Lantus.
Source: Business Insider
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