1978 Genentech produces biosynthetic human insulin in Escherichia coli bacteria using recombinant DNA techniques, licenses to Eli Lilly
1981 Novo Nordisk chemically and enzymatically converts porcine to human insulin
1982 Genentech synthetic human insulin (above) approved
1983 Eli Lilly and Company produces biosynthetic human insulin with recombinant DNA technology, Humulin
1985 Axel Ullrich sequences a human cell membrane insulin receptor. 1988 Novo Nordisk produces recombinant biosynthetic human insulin
1996 Lilly Humalog "lispro" insulin analogue approved. 2000 Sanofi Aventis Lantus insulin "glargine" analogue approved for clinical use in the US and Europe. 2004 Sanofi Aventis Apidra insulin "glulisine" insulin analogue approved for clinical use in the US. 2006 Novo Nordisk Levemir "detemir" insulin analogue approved for clinical use in the US. Medical uses
Insulin is used to treat a number of diseases including diabetes and its acute complications such as diabetic ketoacidosis and hyperosmolar hyperglycemic states. It is also used along with glucose to treat high blood potassium levels. Use during pregnancy is relatively safe for the baby. Insulin was formerly used in a psychiatric treatment called insulin shock therapy. Side effects
Some side effects are hypoglycemia (low blood sugar), hypokalemia (low blood potassium), and allergic reactions. Allergy to insulin affected about 2% of people, of which most reactions are not due to the insulin itself but to preservatives added to insulin such as zinc, protamine, and meta-cresol. Most reactions are Type I hypersensitivity reactions and rarely cause anaphylaxis. A suspected allergy to insulin can be confirmed by skin prick testing, patch testing and occasionally skin biopsy.
Constants should be set by a physician or clinical pharmacist. Abuse
The abuse of exogenous insulin carries with it an attendant risk of hypoglycemic coma and death when the amount used is in excess of that required to handle ingested carbohydrate. Acute risks include brain damage, paralysis, and death. Symptoms may include dizziness, weakness, trembling, palpitations, seizures, confusion, headache, drowsiness, coma, diaphoresis and nausea. All persons with overdoses should be referred for medical assessment and treatment, which may last for hours or days.Data from the US National Poison Data System (2013) indicates that 89.3% of insulin cases reported to poison centers are unintentional, as a result of therapeutic error. Another 10% of cases are intentional, and may reflect attempted suicide, abuse, criminal intent, secondary gain or other unknown reasons. Hypoglycemia that has been induced by exogenous insulin can be chemically detected by examining the ratio of insulin to C-peptide in peripheral circulation. It has been suggested that this type of approach could be used to detect exogenous insulin abuse by athletes.The possibility of using insulin in an attempt to improve athletic performance was suggested as early as the 1998 Winter Olympics in Nagano, Japan, as reported by Peter Sönksen in the July 2001 issue of Journal of Endocrinology. The question of whether non-diabetic athletes could legally use insulin was raised by a Russian medical officer.