Amid the debate about why insulin costs so much lies a second question: if the hormone can be delivered more efficiently, will people with diabetes need less insulin? It’s not just a question that’s come up in the era of the artificial pancreas, as people with type 1 diabetes (T1D) work with technology that uses an algorithm to anticipate their blood glucose levels and make constant adjustments to their insulin needs. A company called Diasome is pushing the idea further, by trying to take insulin to the place where it would go if created by islet cells and released by a human pancreas: straight to the liver.