Mechanism of action
Through recombinant DNA technology, the final lysine and proline residues on the C-terminal end of the B-chain are reversed. This modification does not alter receptor binding, but blocks the formation of insulin dimers and hexamers. This allows larger amounts of active monomeric insulin to be immediately available for postprandial injections. Chemistry
It is a manufactured form of human insulin where the amino acids lysine and proline have been switched at the end of the B chain of the insulin molecule. This switch of amino acids mimics Insulin-like growth factor 1 which also has lysine (K) and proline (P) in that order at positions 27 and 28. Cost
In the United States, the price of for a vial of Humalog increased from US$35 in 2001 to US$234 2015, or US$10.06 and US$29.36 per 100 units. In April 2019, Eli Lilly and Company announced they would produce a version selling for US$137.35 per vial, about half the then-current cost. The chief executive said that this was a contribution "to fix the problem of high out-of-pocket costs for Americans living with chronic conditions", but Patients for Affordable Drugs Now said this was just a public relations move, as "other countries pay US$20 for a vial of insulin. "The cost in the United Kingdom was between £1.66 and £1.96 per 100 units, in 2017.
Distal clavicular osteolysis
Distal clavicular osteolysis (DCO) is often associated with problems weightlifters have with their acromioclavicular joints due to high mechanical stresses put on the clavicle as it meets with the acromion. This condition is often referred to as "weight lifters shoulder". Medical ultrasonography readily depicts resorption of the distal clavicle as irregular cortical erosions, whereas the acromion remains intact. Associated findings may include distended joint capsule, soft tissue swelling, and joint instability. A common surgery to treat recalcitrant DCO is resection of distal clavicle by removing a few millimetres of bone from the very end of the bone. See also
Osteolytic lesion
Biomineralization

References


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