Another “smart” idea

Another “smart” idea

It seems like a day cannot go by without someone coming up with another “smart” idea to help patients with diabetes. First we had “smart” insulin pumps, then “smart” glucose meters, coming soon “smart” insulin pens and today “smart” insulin. Yes researchers at the University of Utah are working on a smart insulin which according to story published in The Guardian;

“The smart insulin, known as Ins-PBA-F, is engineered to bind to a blood protein, called albumin, as soon as it is injected. This means it is essentially stored in a reservoir. The insulin is then released when blood sugar levels reach a certain threshold, meaning it can act to lower the circulating glucose.”

Now these researchers aren’t the only ones looking for “smarter” insulins, in actuality they are one of many. Most of the research is focused on short-acting insulin, insulin taken with meals or snacks. The general theory is IF insulin only worked when it needed to, patients would achieve better outcomes and avoid severe hypoglycemic events. Basically what researchers want is to mimics how a pancreases works in a person who does not have diabetes, producing insulin only when it’s needed.

Yet as we have seen recently short-acting insulin’s aren’t the only insulin’s which need to get smarter as both Novo Nordisk (NYSE:NVO) and Sanofi (NYSE:SNY) have smarter long-acting insulin’s before the FDA, neither of which have been approved. The theory with these “smarter” long-acting insulin’s is twofold, fewer injections combined with fewer hypoglycemic events.

While Diabetic Investor applauds this research as better insulin’s both short and long acting would benefit patients. We also understand that nothing much will change IF patients don’t know how to use these “smarter” insulin’s. Sanofi is making a big deal out of the “fact” that Toujeo™, their new and “smarter” long-acting insulin has fewer hypoglycemic events than Lantus, the insulin Toujeo is designed to replace. Although Diabetic Investor isn’t convinced Toujeo will amount to anything, we’d be interested to see study that took current Lantus patients, give them some solid insulin education and then see how many hypoglycemic events they experience compared to those using Toujeo.

Actually there is no need for such a study as it will show what every other study on the subject shows, educated patients experience better outcomes and avoid many of the complications associated with poorly controlled diabetes. These studies also show that when educated insulin patients also have fewer hypoglycemic events. Imagine that all these dumb insulin’s in the hands of smart patients get the job done just fine thank you very much.

Now we’re sure there are some who are saying wait a minute here don’t smarter insulin’s require less patient education? The answer is a resounding NO which is exactly our point. Even if an insulin is smarter when taken in excess because the patients does not understand how to count carbs or does not understand what insulin on board means, will still experience a hypoglycemic event. This is what happens when too much insulin is taken and it doesn’t matter whether the patient has taken smart or dumb insulin.

Theoretically these newer smarter insulin’s that only work when needed would be a huge step forward. However we are years away, if ever, from seeing these “smarter” insulin’s on the market. Right now only a handful of rats have seen the benefit and we should all know that it’s a long way from helping the diabetic rodent population to actually helping real humans with diabetes. We certainly hope this research and subsequent human trails are successful, yet in the meantime maybe it would be a good idea if patients following insulin therapy today with all the dumb insulin’s on the market were given a little help. Yes we know it’s not exciting or sexy it just works and in our opinion that’s all that matters.