Monday Medical: Recent advances in insulin |

Monday Medical: Recent advances in insulin

Susan Cunningham
For Steamboat Pilot & Today

This article is the second part of a two-part series. The first installment covered what insulin is and how it was discovered.

In the hundred years since insulin was discovered, scientists have found various ways to enhance this life-saving medication. Below, Dr. Jessica Devin, an endocrinologist at UCHealth Endocrinology Clinic in Steamboat Springs, outlines some of the ways insulin has changed, with an eye on changes that are still to come.

New types of insulin

One of the major changes to this century-old medication is the development of types of insulin that can work faster or last longer.

Devin has seen firsthand the impact of these new varieties of insulin on patients’ lives. Twenty years ago, people who were diagnosed with diabetes often had to adhere to a strict diet and schedule for meals and could still face complications from blood sugars that were too high or too low. But new types of insulin give people more freedom while making it easier to manage blood sugar levels.

“Insulins have progressed in the past 20 years to be much more nimble and flexible,” Devin said. “We no longer say, ‘You have diabetes; now you have to change your life,’ but we can say, ‘How can you adapt diabetes management to fit your life?’”

Shorter-acting insulins have been modified so they’re quickly absorbed and used up; long-acting insulins stay active for 12 or 24 hours, with one lasting 40 hours.

“It’s still the basic insulin peptide hormone, but it’s been modified so it has different peaks and tapering,” Devin said.

New insulin delivery methods

There are also a variety of ways to deliver insulin, such as pens and pumps.

Instead of drawing up insulin from a vial, an insulin “pen” allows patients to click to the proper dose and quickly inject the medication.

“A lot of patients have needle phobias, and the idea of drawing up a syringe can be inconvenient and scary,” Devin said. “The pens make that much easier and are much more convenient to carry and use.”

With an insulin pump, insulin is delivered through a small tube under the skin, eliminating the need for shots and allowing patients to better customize the amount and timing of insulin.

With “closed-loop systems,” a device that monitors blood glucose communicates with the pump, automatically adjusting insulin as needed and allowing for improved and easier management of blood sugar levels.

The importance of finding the right insulin

Devin recommends working closely with your health care provider to determine what works best for you.

“It can depend on how someone reacts to a certain insulin or what their job, schedule, diet and exercise are like,” Devin said. “We’ll ask patients about all of those to help figure out what might work best.”

Devin recommends patients keep notes on what has and hasn’t worked in the past.

“The paperwork can be very easy if someone comes in and says, ‘I’ve definitely tried that, and it doesn’t work, and here’s why,’” Devin said. “If a patient comes in and has no idea what they’ve tried in the past, it can be like starting from scratch.”

The future of insulin

A key area of focus with insulin is making the medication more affordable. While new generics will help, it can still be a challenge to keep up with which types of insulin are preferred by different insurance plans.

“The people who discovered insulin felt it was such an important, life-saving medication that everyone should have access to it, and it should never be limited in any way, so they sold the patent for $1,” Devin said. “There’s a big fight for insulin affordability. We have that issue with lots of medications, but insulin is a big one, because it is so common and necessary for people to stay alive.”

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