ReviewDiabetologia2021
A global perspective on the issue of access to insulin.
Review in Diabetologia, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 52 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
52 citing papers in PubMed, 1 synthesis or guideline pooled it, 110 citations in OpenAlex.
- Impact of diabetes on COVID-19 mortality and hospital outcomes from a global perspective: An umbrella systematic review and meta-analysis.Endocrinology, diabetes & metabolism · 2022Pooled it
- A randomized pharmacokinetic and pharmacodynamic trial of two regular human insulins demonstrates bioequivalence in type 1 diabetes and availability of biosimilar insulin may improve access to this medication.Diabetes, obesity & metabolism · 2022Trial
- Article
- The Lived Experience of Adolescents With Type 1 Diabetes Mellitus in Bahir Dar, Ethiopia: Phenomenological Study.JMIR diabetes · 2026Article
- Integrated UPLC-MS/MS profiling and network pharmacology-based analysis of the anti-hyperglycemic potential of Baihu Jia Renshen Decoction combined with Sanghuangporus vaninii extract in mice.Journal of molecular histology · 2026Article
- Insulin regimens for adults living with type 1 diabetes mellitus.The Cochrane database of systematic reviews · 2026Article
- Review
- Plant- and Microalgae-Based Biotechnological Strategies for Affordable and Non-Invasive Delivery of Antidiabetic Peptides.Pharmaceutics · 2026Review
- Factors Accounting for Pharmacodynamic Variability of Basal Insulin Preparations in Euglycemic Clamp Settings in Healthy Individuals.Clinical pharmacokinetics · 2026Article
- On-demand insulin manufacturing using cell-free systems with an "on-column" conversion approach.New biotechnology · 2025Article
- Insulin Rationing Persists Despite Policy Changes: Repeated Cross-Sectional Studies, 2017 vs 2024.Journal of general internal medicine · 2025Article
- Rethinking and redefining the definitions and how we measure availability and affordability of medicines and technologies for non-communicable diseases.BMJ global health · 2025Article
- The health economics of insulin therapy: How do we address the rising demands, costs, inequalities and barriers to achieving optimal outcomes.Diabetes, obesity & metabolism · 2025Article
- Replenish Revenue by Low-Cost Medicines, an Institution-Specific Action to Improve Access to High-Cost Medicines Used for Chronic Illness in Ethiopia: Narrative Review.Health science reports · 2025Article
- Article
- Prices of Anti-Diabetic Drugs Sold in Private Pharmacies in Côte d'Ivoire, 2023: A Secondary Analysis.ClinicoEconomics and outcomes research : CEOR · 2025Article
- An Empirical Review of Key Glucose Monitoring Devices: Product Iterations and Patent Protection.Journal of diabetes science and technology · 2025Review
- A Scoping Review of GIS Mapping of Type 1 Diabetes in Children: Identifying Current Gaps and Future Research Directions Using PRISMA-ScR.Current diabetes reviews · 2025Article
- Disparities in Diabetes Technology Uptake in Youth and Young Adults With Type 1 Diabetes: A Global Perspective.Journal of the Endocrine Society · 2024Review
- Barriers to WHO prequalification of similar biotherapeutic insulin.Bulletin of the World Health Organization · 2024Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 2 institutions in 4 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The discovery of insulin in 1921 changed the prognosis for people with type 1 diabetes. A century later, availability and affordability of insulin remain a challenge in many parts of the globe. Using the WHO's framework on understanding the life cycle of medicines, this review details the global and national challenges that affect patients' abilities to access and afford insulin. Current research and development in diabetes has seen some innovations, but none of these have truly been game-changing. Currently, three multinational companies control over 95% of global insulin supply. The inclusion of insulin on the WHO's Prequalification Programme is an opportunity to facilitate entry of new companies into the market. Many governments lack policies on the selection, procurement, supply, pricing and reimbursement of insulin. Moreover, mark-ups in the supply chain also affect the final price to the consumer. Whilst expenses related to diabetes are mostly covered by insurance in high-income countries, many patients from low- and middle-income countries have to pay out of their own pockets. The organisation of diabetes management within the healthcare system also affects patient access to insulin. The challenges affecting access to insulin are complex and require a wide range of solutions. Given that 2021 marks the centenary of the discovery of insulin, there is need for global advocacy to ensure that the benefits of insulin and innovations in diabetes care reach all individuals living with diabetes.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.