CareTalk: Healthcare. Unfiltered.
Why Insulin Never Reaches the Liver
Why It Matters
Understanding insulin’s failure to target the liver reveals a critical gap in diabetes treatment, as the liver regulates both glucose storage and release. Addressing this could improve glycemic control and reduce complications, making the research behind Diastome highly relevant for patients, clinicians, and investors in the evolving diabetes therapeutics landscape.
Key Takeaways
- •Radioactive insulin traced everywhere except liver in rats.
- •Liver uniquely stores and releases glucose under insulin control.
- •Father’s research sparked liver‑targeted insulin delivery technology.
- •Host’s type‑1 diagnosis redirected career toward biotech entrepreneurship.
- •HDV product aims to deliver insulin directly to liver.
Pulse Analysis
The episode opens with a striking experiment from decades ago: a Columbia researcher attached a radioactive tag to insulin and injected it peripherally into rats. When the animals were dissected, investigators found the tracer throughout the body—except the liver. This unexpected omission highlighted the liver’s unique role as the sole organ that both stores glucose after meals and releases it during fasting, making it a critical hub for glucose homeostasis.
Recognizing this gap, the host’s father, a pioneer behind the HDV platform, devoted his career to engineering insulin that actually reaches the liver. Modern liver‑targeted insulin delivery promises tighter glycemic control, reduced peripheral side effects, and a more physiological mimic of natural insulin action. The discussion underscores how this approach could reshape treatment algorithms for both type 1 and type 2 diabetes, positioning HDV as a potential first‑in‑class therapeutic that aligns drug distribution with the organ that governs glucose balance.
Beyond the science, the host shares a personal journey from a music‑focused undergraduate to a biotech entrepreneur after an unexpected type 1 diabetes diagnosis in graduate school. That experience, coupled with his father’s research, fueled a mission‑driven business model aimed at translating laboratory insights into marketable therapies. For investors and industry leaders, the story illustrates how personal health challenges can spark innovative solutions that address unmet clinical needs, driving both patient impact and commercial opportunity.
Episode Description
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The liver is the only organ in the body that can release stored glucose to prevent low blood sugar. So why has injected insulin never been able to reach it?
In this clip from our episode “Finding a Solution for GLP-1 Side Effects”, host David E. Williams and Bob Geho, Founder and CEO of Diasome, break down the biological gap at the heart of diabetes treatment and how a father's decades of research into liver-targeted insulin delivery became the founding idea behind Diasome.
🎙️⚕️ABOUT BOB GEHO
Bob Geho is the Chief Executive Officer of Diasome Pharmaceuticals, a clinical-stage biopharmaceutical company developing portal-hepatic -targeted therapies designed to act at the source of metabolic regulation.
Under his leadership, Diasome is advancing its proprietary Hepatocyte-Directed Vesicle (HDV) platform, which targets liver hepatocytes and the portal hepatic region, where metabolic control is centered. The company's lead clinical program, HDV-Insulin, applies this approach to insulin therapy — grounded in the principle that therapies working with the body's natural physiology may produce meaningfully better outcomes. The HDV platform is also being explored across GLP-1 and serotonin programs.
Bob's work in hepatic-directed drug delivery spans more than three decades, including helping lead the first successful human clinical study of liver-targeted insulin in Type 1 diabetes patients. He co-founded Diasome in 2004 and has since guided the company through multiple rounds of financing and into clinical development. He also co-founded SDG, Inc., a Cleveland-based holding company that has supported the creation of multiple life sciences startups and strategic partnerships.
He holds an MBA from Case Western Reserve University.
🎙️⚕️ABOUT HEALTH BIZ PODCAST
HealthBiz is a CareTalk podcast that delivers in-depth interviews on healthcare business, technology, and policy with entrepreneurs and CEOs. Host David E. Williams — president of the healthcare strategy consulting boutique Health Business Group — is also a board member, investor in private healthcare companies, and author of the Health Business Blog. Known for his strategic insights and sharp humor, David offers a refreshing break from the usual healthcare industry BS.
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For over 20 years, Health Business Group has helped healthcare software companies, tech-enabled services businesses, life sciences companies, and payers make smarter strategic decisions. Led by podcast host David Williams, the firm advises clients on sharpening AI positioning, entering new segments, and building commercial strategies for value-based care. See examples of our work at healthbusinessgroup.com/
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