Clinicians Julio Rosenstock and Stephano del Prato look at upcoming options in insulin-based diabetes therapy with a focus on the molecular strategy and clinical profile of investigational once-weekly insulin.

In this review, the authors provide a comprehensive look at the technologies behind, for example, ultra-long-acting insulin, and in-development oral insulin and tissue-selective insulin. It is made clear how academic research in partnership with the pharmaceutical industry have allowed for the large-scale production of these refined insulin analogues.
Looking to the future, the authors outline how molecular engineering, digitalization and device technology are poised to enable even more advanced insulin-based therapies such as glucose-sensitive analogues.

 

This article includes a narrated video where the authors describe the structural aspects of insulin analog design.

 

In this patient-centric review, the authors use experiences from their own clinical practice to describe how insulin therapies over the past century have prolonged the healthy lifespan of people diagnosed with diabetes. The review also presents lingering challenges and how continued improvement in insulin therapies may help address unmet needs in diabetes care.

As the authors describe in this perspective featured in the inaugural issue of Nature Communications Medicine, the journey that started with the discovery of insulin has not yet ended. The article outlines the several ground-breaking medical and scientific developments inspired by insulin as a model compound and discusses how future advances in peptide- and protein-based therapies for chronic diseases inarguably can be traced back to the insulin-related advances of the past century.

 

Hundred years of insulin innovation: When science meets technology
This commentary starts with a counterfactual approach to understanding how insulin has shaped science in medicine and where we would have been if insulin had not being discovered. Whilst doing so, the authors concisely reflect on how insulin – and other compounds and technologies owing their existence to insulin-related research - can help take us to the next level in diabetes care and beyond.

Insulin innovation during the past century is a prime example of what can happen when academic science and translational biotechnology work together. In this brief commentary, two researchers who have been intimately involved for over three decades describe the developments of advanced insulin analogues. These compounds have been made possible as the result of public-private partnerships that are inarguably also going to shape future developments.