Clinical aspects of monocomponent insulins in the treatment of diabetes.
Conventional insulins, even if recrystallised many times, are found to contain several peptides on gel electrophoresis and are immunogenic. Antibody formation, insulin allergy, fat atrophy, fat hypertrophy and insulin bumps are thought to be largely caused by the impurities rather than by the insulin itself. 'Monocomponent' insulin has recently been prepared in the laboratories of Novo industries Ltd. Theoretically, this insulin should not cause the above complications. A combined clinical trial of monocomponent insulin has been carried out in Johannesburg and Cape Town on 24 patients with diabetes of diverse aetiology, who required insulin. The results of the trial may be summarised as follows: Monocomponent insulin appears to be very effective in patients with insulin allergy, adipopathy, and possibily in some patients in whom diabetes is not controlled with large doses of insulin. The monocomponent insulins deteriorate on storage at room temperature and yield monodesamido insulin. This de-amidation may be associated with persistent circulating antibodies to insulin and pro-insulin and with failure to reduce insulin requirements, but does not interfere with improvement in allergy or adipopathy. Long-standing diabetic patients, who are qell controlled with conventional insulin, are unlikely to gain therapeutic benefit from monocomponent insulin, and may even deteriorate or lose smooth metabolic control.
D000293:Adolescent; D000328:Adult; D000368:Aged; D003920:Diabetes Mellitus / Q000188:drug therapy* / Q000276:immunology; D004340:Drug Contamination; D004355:Drug Stability; D004356:Drug Storage; D005260:Female; D006801:Humans; D007328:Insulin / Q000009:adverse effects / Q000627:therapeutic use*; D007330:Insulin Antibodies / Q000032:analysis; D049528:Insulin, Long-Acting / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D011384:Proinsulin / Q000276:immunology
D007328:Insulin; D007330:Insulin Antibodies; D049528:Insulin, Long-Acting; D011384:Proinsulin