Some science behind the scenes

Natural insulin products

Patients with type 1 diabetes depend on external insulin for their survival, thus insulin is used principally for treatment of type 1 diabetes.

Patients with type 2 diabetes are often insulin resistant and, because of such resistance, may suffer from a "relative" insulin deficiency. Some patients with type 2 diabetes, however, may eventually require insulin if the other medications in this list fail to control blood glucose levels adequately. Over 40% of those with Type 2 diabetes require insulin as part of their diabetes management plan.

Unlike many medicines, insulin currently cannot be taken orally because, like nearly all other proteins introduced into the gastrointestinal tract, it is reduced to fragments, whereupon all activity is lost. Instead, insulin is usually taken as subcutaneous injections by single-use syringes with needles, via an insulin pump, or by repeated-use insulin pens with needles.

Biosynthetic "human" insulin is now manufactured for widespread clinical use using recombinant DNA technology. More recently, researchers have succeeded in introducing the gene for human insulin into plants and in producing insulin in them, to be specific safflower. This technique is anticipated to reduce production costs.

Several of these slightly modified versions of human insulin, while having a clinical effect on blood glucose levels as though they were exact copies, have been designed to have somewhat different absorption or duration of action characteristics. They are usually referred to as "insulin analogues". For instance, the first one available, insulin lispro, does not exhibit a delayed absorption effect found in regular insulin, and begins to have an effect in as little as 15 minutes. Other rapid-acting analogues are NovoRapid and Apidra, with similar profiles.

Yet again, it is often quite difficult to get the balance and dose right especially if the person does not adhere to a strict diet of low carbohydrate/low sugar and hypoglaecemia can result – low blood sugar.