Understanding Insulin's Role in Diabetes Management

Is insulin truly essential for individuals with Type 2 diabetes? Must it be prescribed in every case?

The term "insulin" often evokes mixed feelings among diabetics. This hormone acts as a signaling molecule for cells, especially after we consume food. When we eat, our digestive system breaks down the food into simpler components, such as glucose, which then enters the bloodstream through the intestines.

Insulin is secreted by the pancreas to indicate to our cells that it's time to absorb glucose—much like a bell ringing in a factory or school to signal lunch breaks. When the insulin "bell" rings, cells are prompted to take in glucose from the bloodstream.

However, some individuals experience issues with their pancreatic functions. In Type 1 diabetes, for instance, the beta cells in the pancreas are unable to produce enough insulin, making it challenging for the body to signal its cells effectively.

Interestingly, insulin production is relatively inexpensive:

A study from 2018 estimated that the manufacturing cost of a vial of human insulin ranges from $2.28 to $3.42, while analog insulin costs between $3.69 and $6.16. The annual cost for human insulin was projected to be between $48 and $71 per patient, whereas analog insulin might range from $78 to $133.

Despite this, prices in the U.S. are significantly inflated. In 2018, the average price of insulin in the U.S. was $98.70, compared to $6.94 in Australia, $12.00 in Canada, and $7.52 in the UK.

Unfortunately, individuals with Type 1 diabetes require consistent insulin injections due to their pancreas's inability to produce adequate amounts. But what about those with Type 2 diabetes? Insulin is frequently prescribed for them as well.

The prescribing of insulin for Type 2 diabetics overlooks a critical issue: insulin resistance. When facing resistance, the most effective approach is to reduce that resistance rather than simply increasing insulin levels.

Rather than trying to move ten heavy boxes at once, it may be more feasible to carry one or two at a time. The weight of ten boxes is much more overwhelming than that of a single box. Breaking down the work into smaller, manageable tasks can make it easier to accomplish.

In this context, injecting more insulin into someone whose body is resistant to its effects is not a solution. This approach is reminiscent of the outdated corporate mentality of "beatings will continue until morale improves," which reflects a disregard for the underlying issues at play.

We cannot expect our cells to respond positively to an overwhelming influx of insulin as if they have no choice in the matter. We need to address the root causes of insulin resistance instead of merely treating the symptoms.

However, due to the economic dynamics of healthcare, prescribing insulin becomes a convenient yet partial solution. Patients are often not fully informed, and the healthcare landscape prioritizes profits over scientific understanding.

In the U.S., three major companies—Novo Nordisk, Sanofi, and Eli Lilly—dominate the insulin market, creating an oligopoly that discourages competitive pricing. This scenario resembles a playground where a few bullies enforce their rules, leaving others powerless to challenge them.

In contrast, in markets like China, these companies had to reduce their prices due to competition from local manufacturers, illustrating that market dynamics can vary significantly.

Just as drug lords operate through a network of intermediaries, insulin manufacturers rely on doctors to prescribe their products, effectively marketing them to patients without direct engagement. Consequently, doctors may not prioritize cost considerations as much as their patients do.

For Type 1 diabetes patients, the risk of serious health complications arises from the inability to afford insulin. Unfortunately, there is little incentive for manufacturers to create cheaper alternatives since they can continue to reap substantial profits.

While Type 2 diabetics need to confront their insulin resistance, which often stems from chronic inflammation, simply increasing insulin levels is not a viable solution. Addressing blood glucose levels is important, but we must also consider the other factors contributing to insulin resistance.

This often means reducing carbohydrate intake significantly. Many dining options, supermarket products, and food delivery services offer meals that are high in carbohydrates.

In this video, we explore insulin treatment options for Type 2 diabetes and the importance of understanding when insulin is needed.

This video discusses the circumstances under which insulin becomes essential for managing Type 2 diabetes effectively.