Editing Insulin (section)

== Medical uses ==
{{Main|Insulin (medication)}}
[[File:Inzulín.jpg|thumb|right|Two vials of insulin. They have been given trade names, Actrapid (left) and NovoRapid (right) by the manufacturers.]]
Biosynthetic [[human insulin]] (insulin human rDNA, INN) for clinical use is manufactured by [[Recombinant DNA#Synthetic insulin production using recombinant DNA|recombinant DNA]] technology.<ref name=recombination /> Biosynthetic human insulin has increased purity when compared with extractive animal insulin, enhanced purity reducing antibody formation. Researchers have succeeded in introducing the gene for human insulin into plants as another method of producing insulin ("biopharming") in [[safflower]].<ref>{{cite web | title = From SemBiosys, A New Kind Of Insulin | work = Inside Wall Street | date = 13 August 2007 | vauthors = Marcial GG  | url = http://www.businessweek.com/magazine/content/07_33/b4046083.htm | archive-url = https://web.archive.org/web/20071117132739/http://www.businessweek.com/magazine/content/07_33/b4046083.htm | archive-date = 17 November 2007 | url-status = dead}}</ref> This technique is anticipated to reduce production costs.

Several analogs of human insulin are available. These [[insulin analog]]s are closely related to the human insulin structure, and were developed for specific aspects of glycemic control in terms of fast action (prandial insulins) and long action (basal insulins).<ref>[[Insulin analog]]</ref> The first biosynthetic insulin analog was developed for clinical use at mealtime (prandial insulin), [[Humalog]] (insulin lispro),<ref>{{cite journal | vauthors = Vecchio I, Tornali C, Bragazzi NL, Martini M | title = The Discovery of Insulin: An Important Milestone in the History of Medicine | journal = Frontiers in Endocrinology | volume = 9 | pages = 613 | date = 23 October 2018 | pmid = 30405529 | pmc = 6205949 | doi = 10.3389/fendo.2018.00613 | doi-access = free }}</ref> it is more rapidly absorbed after subcutaneous injection than regular insulin, with an effect 15&nbsp;minutes after injection. Other rapid-acting analogues are [[NovoRapid]] and [[Apidra]], with similar profiles.<ref>{{cite journal | vauthors = Gast K, Schüler A, Wolff M, Thalhammer A, Berchtold H, Nagel N, Lenherr G, Hauck G, Seckler R | title = Rapid-Acting and Human Insulins: Hexamer Dissociation Kinetics upon Dilution of the Pharmaceutical Formulation | journal = Pharmaceutical Research | volume = 34 | issue = 11 | pages = 2270–2286 | date = November 2017 | pmid = 28762200 | pmc = 5643355 | doi = 10.1007/s11095-017-2233-0 }}</ref> All are rapidly absorbed due to amino acid sequences that will reduce formation of dimers and hexamers (monomeric insulins are more rapidly absorbed). Fast acting insulins do not require the injection-to-meal interval previously recommended for human insulin and animal insulins. The other type is long acting insulin; the first of these was [[Lantus]] (insulin glargine). These have a steady effect for an extended period from 18 to 24&nbsp;hours. Likewise, another protracted insulin analogue ([[Levemir]]) is based on a fatty acid acylation approach. A [[myristic acid]] molecule is attached to this analogue, which associates the insulin molecule to the abundant serum albumin, which in turn extends the effect and reduces the risk of hypoglycemia. Both protracted analogues need to be taken only once daily, and are used for type 1 diabetics as the basal insulin. A combination of a rapid acting and a protracted insulin is also available, making it more likely for patients to achieve an insulin profile that mimics that of the body's own insulin release.<ref>{{cite journal | vauthors = Ulrich H, Snyder B, Garg SK | title = Combining insulins for optimal blood glucose control in type I and 2 diabetes: focus on insulin glulisine | journal = Vascular Health and Risk Management | volume = 3 | issue = 3 | pages = 245–54 | date = 2007 | pmid = 17703632 | pmc = 2293970 }}</ref><ref>{{cite journal | vauthors = Silver B, Ramaiya K, Andrew SB, Fredrick O, Bajaj S, Kalra S, Charlotte BM, Claudine K, Makhoba A | title = EADSG Guidelines: Insulin Therapy in Diabetes | journal = Diabetes Therapy | volume = 9 | issue = 2 | pages = 449–492 | date = April 2018 | pmid = 29508275 | pmc = 6104264 | doi = 10.1007/s13300-018-0384-6 }}</ref> Insulin is also used in many cell lines, such as CHO-s, HEK 293 or Sf9, for the manufacturing of monoclonal antibodies, virus vaccines, and gene therapy products.<ref>{{Cite news|date=22 October 2021|title=Insulin Human for innovative biologics|newspaper=Novo Nordisk Pharmatech|url=https://novonordiskpharmatech.com/products/insulin-human-af/}}</ref>

Insulin is usually taken as [[subcutaneous injection]]s by single-use [[syringe]]s with [[hypodermic needle|needles]], via an [[insulin pump]], or by repeated-use [[insulin pen]]s with disposable needles. [[Inhaled insulin]] is also available in the U.S. market.

The Dispovan Single-Use Pen Needle by HMD<ref>{{Cite web |title=क्या आप डायबिटीज के मरीज है? अगर हां तो उचित दाम में मिलेगी HMD की डिस्पोवन इंसुलिन पेन नीडल |url=https://www.amarujala.com/lifestyle/fitness/hmd-dispovan-insulin-pen-needles-for-diabetes-patients |access-date=8 July 2022 |website=amarujala.com}}</ref> is India’s first insulin pen needle that makes self-administration easy. Featuring extra-thin walls and a multi-bevel tapered point, these pen needles prioritise patient comfort by minimising pain and ensuring seamless medication delivery. The product aims to provide affordable Pen Needles to the developing part of the country through its wide distribution channel. Additionally, the universal design of these needles guarantees compatibility with all insulin pens.

Unlike many medicines, insulin cannot be taken [[Oral administration|by mouth]] because, like nearly all other proteins introduced into the [[Human gastrointestinal tract|gastrointestinal tract]], it is reduced to fragments, whereupon all activity is lost. There has been some research into ways to protect insulin from the digestive tract, so that it can be administered orally or sublingually.<ref name="pmid27364922">{{cite journal | vauthors = Wong CY, Martinez J, Dass CR | title = Oral delivery of insulin for treatment of diabetes: status quo, challenges and opportunities | journal = The Journal of Pharmacy and Pharmacology | volume = 68 | issue = 9 | pages = 1093–108 | year = 2016 | pmid = 27364922 | doi = 10.1111/jphp.12607 | doi-access = free }}</ref><ref name="pmid27014614">{{cite journal | vauthors = Shah RB, Patel M, Maahs DM, Shah VN | title = Insulin delivery methods: Past, present and future | journal = International Journal of Pharmaceutical Investigation | volume = 6 | issue = 1 | pages = 1–9 | year = 2016 | pmid = 27014614 | pmc = 4787057 | doi = 10.4103/2230-973X.176456 | doi-access = free }}</ref>

In 2021, the [[World Health Organization]] added insulin to its [[WHO Model List of Essential Medicines|model list of essential medicines]].<ref>{{Cite web| vauthors = Sharma NC |date=1 October 2021|title=WHO adds new drugs to its essential medicines' list|url=https://www.livemint.com/news/world/who-adds-new-drugs-to-its-essential-medicines-list-11633112107174.html|access-date=9 October 2021|website=mint|language=en}}</ref>

Insulin, and all other medications, are supplied free of charge to people with diabetes by the [[National Health Service]] in the countries of the United Kingdom.<ref>{{cite web | title=Free prescriptions (England) | website=Diabetes UK | url=https://www.diabetes.org.uk/guide-to-diabetes/life-with-diabetes/free-prescriptions | quote=If you use insulin or medicine to manage your diabetes, ... you don't pay for any item you're prescribed.|access-date=21 November 2022}}</ref>