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Insulin Therapy

An Overview of Diabetes


According to the Centers for Disease and Control and Prevention (CDC), Diabetes is a chronic disease in which the body cannot properly process or convert food into energy. Our bodies regularly break down the food we eat into sugar (glucose), which is then released into the bloodstream, and this process is regulated by a protein hormone called insulin. In short, insulin acts as the key that opens the channel to allow the sugar to enter the cells of our bodies, which is then used for energy.


The role of insulin hormones in the human body (Designua/shutterstock.com).


However, patients living with diabetes are unable to produce insulin or cannot properly use the hormone. This leads to the buildup of sugar in the blood, damaging organs, nerves, blood vessels, and other bodily functions.


The two main types of diabetes include type 1 diabetes and type 2 diabetes.


Diabetes Canada refers to type 1 diabetes as an insulin-dependant disease, where people cannot produce their own insulin because their body is attacking the pancreas; therefore, those living with this disease cannot regulate their blood sugar. Only about 10% of people living with diabetes have type 1 diabetes.

People with type 2 diabetes cannot properly use or produce enough insulin, leading to disorders in bodily functions such as the nervous, immune, and circulatory systems. According to the CDC, roughly 90% of people with diabetes have type 2, and obesity plays a significant risk in the development of this disease.


The Development of Insulin Treatment


Insulin was reportedly first used to treat diabetes in 1922. Initially, it was widely believed that a complex method of secretion (the process of releasing a substance from a material) in the pancreas was the key to treating diabetes. However, with the suggestion proposed by Frederick Banting, a small team of researchers began experimentation on insulin treatments in 1921. First discovered by Sir Frederick G. Banting, Charles Best, JJR Macloed, and purified by James B. Collip, these researchers from the University of Toronto made revolutionary history in the medical field.


Dr. Charles H. Best and Dr. G.R. Williams experimenting in the lab of the Charles H. Best Institute at the University of Toronto (National Film Board of Canada / Library and Archives Canada).


How Does Insulin Therapy Work?


Insulin Therapy is essential in treating patients with type 1 diabetes but may not be necessary for those with type 2 diabetes if other treatments are effective. To treat diabetes, human Insulin is a liquid solution injected under the skin into the body multiple times a day. Recent innovations also allow Insulin to be steadily pumped in multiple doses into the system or even inhaled. Unfortunately, Insulin cannot be consumed as a pill because the digestive system will break down the substance before the treatment process can work. Prescribed by a doctor and depending on the type/brand, Insulin is taken before each meal, as diabetic patients often do not have enough Insulin to move the sugar from the food they consume into their cells. For instance, according to the American Academy of Family Physicians, patients taking Regular Insulin or long-acting Insulin should generally be taken 15-30 minutes before each meal. In contrast, Insulin Lispro (a different brand) should be taken in less than 15 minutes.


Image is courtesy of Melissa Johnson/Flickr.


Benefits


Increased Life Expectancy


Studies show that before the invention of insulin, the average life expectancy for patients with type 1 diabetes was less than three years. In the modern era, research shows that the average lifespan for men with diabetes is 66.2 years and 68.1 years for women, which is a substantial increase. With insulin therapy being one of the most common and essential treatments for type 1 diabetes, it is clear that it has extended the life of a disease that was once thought to a death sentence.


Decreased Blood Sugar to Prevent Harmful Symptoms of Diabetes


Hyperglycemia, also known as high blood sugar, occurs when there is too much sugar in the blood cells due to a lack of insulin, which can harm the vessels supplying blood to organs, leading to serious health complications with organ functions. Proving to be highly effective in raising insulin levels in most patients, this treatment is most effective in controlling blood sugar levels and preventing acute emergencies.


Drawbacks


Medical Risks


While insulin therapy prevents hyperglycemia, it can increase the risk of hypoglycemia, also known as low blood sugar. According to Mayo Clinic, the blood sugar can drop too low when too much insulin is taken and when a person with diabetes eats too little or exercises more than usual, as sugar is converted into energy. If untreated for a long time, low blood sugar can lead to a loss of consciousness, seizures, and death because the brain needs the glucose to function. Therefore, it is imperative to constantly monitor and maintain a balance between insulin, food intake, and exercise activity to avoid the consequences of an overdose.


Accessibility


A major issue for many Americans living with diabetes is the overwhelming cost of purchasing insulin. According to Diabetes.co.uk, the average price per unit for all types of insulin in the United States is $98.70, which is significantly higher than the average price in other countries. Many who cannot afford health insurance choose to purchase insulin at cash value as a short-term solution. To save up for insurance, diabetics may choose to ration their insulin or forgo the treatment entirely. Unfortunately, there have been cases where patients living with type 1 diabetes have lost their lives because of how costly insulin is.


Why is this the case? Having a unique healthcare system that is not universally funded, insurance is covered by both private and public insurance plans. Unfortunately, pharmaceutical companies take advantage of the vulnerable population willing to pay high prices to acquire a life-saving drug; therefore, they can raise their prices without fear of losing business. Additionally, monopolies of pharmaceutical companies that produce and sell insulin mean there is no competition to drive down the prices. This is because insulin is still under patent protection, making it extremely difficult for other companies to replicate, produce, or sell the same product.


While gradual changes are being made to increase accessibility for insulin, many still question the ethicality of the insulin production business in the United States and the lack of universal healthcare as a fundamental human right.



Article author: Rachel Weng

Article editors: Sherilyn Wen, Stephanie Sahadeo