Metabolic control following transfer from mixed bovine-porcine insulin to human insulin in subjects with IDDM: influence of the presence of insulin antibodies.
Although no distinct advantage of Human insulin (HI) over mixed Bovine-Porcine insulin (BPI) including antigenicity has been noted, initiation of therapy with HI in subjects with new onset IDDM as well as changeover from BPI to HI regimen even in subjects with well controlled DM with BPI has recently become a routine clinical practice. In this study, we assessed metabolic control by determination of fasting plasma glucose and HbA1C levels as well as serum cholesterol and triglyceride concentrations in 12 men and 2 women (ages 43-74 yrs) with uncontrolled DM while receiving BPI and again at the end of 6 months following changeover to HI with identical insulin regimen in terms of the type of insulin as well as the dosage. The subjects were divided into two groups according to the presence of antibodies to insulin of both bovine and porcine forms in their sera. Metabolic control improved significantly in 6 subjects, with positive antibody titers to bovine-porcine insulin as reflected by lowering of all metabolic parameters (p < 0.05 of all comparisons). However, the remaining 8 subjects with negative antibody titers failed to show a significant change in any of the parameters. Therefore, this study suggests that a changeover from BPI to HI maybe recommended in subjects with presence of BPI antibodies and not in all DM subjects treated with BPI regimen. Moreover, it may be feasible to initiate therapy with BPI regimen in new onset IDDM and change later to HI on occurrence of BPI antibodies; since if HI regimen is used at onset and antibodies to HI develop; the only option available then, may be the increased dosage of HI.
Kabadi
U M
UM
Endocrinology Section, VA Medical Center, Phoenix, AZ 85020.
Birkenholz
M
M
D000328:Adult; D000368:Aged; D000818:Animals; D001786:Blood Glucose / Q000187:drug effects / Q000378:metabolism*; D002417:Cattle; D002784:Cholesterol / Q000097:blood; D003922:Diabetes Mellitus, Type 1 / Q000097:blood* / Q000188:drug therapy*; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism*; D006801:Humans; D007328:Insulin / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D011994:Recombinant Proteins / Q000627:therapeutic use*; D013552:Swine; D014280:Triglycerides / Q000097:blood
D001786:Blood Glucose; D002784:Cholesterol; D006442:Glycated Hemoglobin; D007328:Insulin; D011994:Recombinant Proteins; D014280:Triglycerides