 The paper reviews the global patent landscape for insulin, finding that while patents on current analogs are set to expire, multinationals continue to file for more patents in larger markets with high disease burdens in emerging middle classes. Off-patent human insolence can manage diabetes effectively, and a practical solution would be to find potential generic manufacturers globally and encourage them to diversify their national insulin markets with acceptable off-patent products for export. This article was authored by Warren A. Kaplan and Reid F. Beale.