Human insulin: Much ado about one amino acid?

Sonnenberg, G. E.; Berger, Michael

doi:10.1007/bf00284450

Cited by 41 publications

(15 citation statements)

References 29 publications

(7 reference statements)

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“…Similar results have generally been found (41,42) and are readily explained by the fact that these insulins have virtually identical intrinsic activity (41,42) and by the fact that the patients studied have had antibodies that bound porcine and human insulin indistinguishably (43) as in this study.…”

Section: Discussionsupporting

confidence: 83%

Adverse Effects of Insulin Antibodies on Postprandial Plasma Glucose and Insulin Profiles in Diabetic Patients Without Immune Insulin Resistance: Implications for Intensive Insulin Regimens

1987

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To assess the possible influence of moderate titer insulin antibodies on diabetic glycemic control, we examined insulin-antibody equilibrium binding characteristics, postprandial glucose tolerance, and plasma free-insulin profiles after subcutaneous injection of both porcine and human insulin (0.15 U/kg) in 12 patients with insulin-dependent diabetes mellitus under conditions stimulating intensive insulin therapy. The patients' antibodies bound porcine and human insulin indistinguishably, and their plasma glucose and free-insulin profiles after ingestion of a standard meal were similar with both insulins. Initial increases in plasma free-insulin levels after injection of both insulins were negatively correlated with both insulin-antibody binding (r = -.55, P less than .006) and postprandial hyperglycemia (peak level r = -.56, P less than .006); the latter was positively correlated with insulin-antibody binding (r = .48, P less than .02). The effects of insulin antibodies on postprandial plasma free-insulin and glucose levels could be accounted for substantially by the association constant of the high-affinity insulin-antibody binding sites (K1); patients in the highest quartile for K1 had significantly slower initial increments in plasma free insulin (0.31 +/- 0.04 vs. 0.46 +/- 0.06 microU/min, P less than .05) and greater postprandial hyperglycemia (peak value 237 +/- 10 vs. 166 +/- 12 mg/dl, P less than .001) than patients in the lowest quartile. We conclude that moderate insulin-antibody titers commonly found in insulin-treated patients can slow the early increase in plasma free insulin after subcutaneous injection and that this impairs postprandial glucose tolerance; such an effect may limit the effectiveness of intensive insulin therapy.

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Section: Discussionsupporting

confidence: 83%

Adverse Effects of Insulin Antibodies on Postprandial Plasma Glucose and Insulin Profiles in Diabetic Patients Without Immune Insulin Resistance: Implications for Intensive Insulin Regimens

1987

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“…The data presented by M.Berger, however, are not suitable to contribute to this clarification. We, on the other hand, strongly agree with one of his earlier statements, namely that "the present vogue for human insulin is not matched by comparable benefits in clinical practice" [6]. We just would like to add that human insulin might even be associated with important disadvantages in a number of insulin-dependent diabetic patients.…”

Section: Dear Sirsupporting

confidence: 73%

Re: Hypoglycaemia (un)awareness: human vs animal insulin

Egger

Teuscher²,

Berger³

1988

Diabetologia

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“…The safety and efficacy of semisynthetic human insulin has been documented in diabetic adults [1]. Other studies published up to now have not shown conclusively whether the use of human insulin in diabetic children with Type 1 diabetes has any advantage compared to highly purified porcine insulin [2][3][4][5][6]. The purpose of the present work was to perform a longitudinal clinical and metabolic study in two similar groups of newly diagnosed diabetic children treated with either semisynthetic human or porcine insulin of equal purity.…”

mentioning

confidence: 99%

Comparison of human and porcine insulin therapies in children with newly diagnosed diabetes mellitus

et al. 1987

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A multicenter, longitudinal study of children below the age of 16 years with newly diagnosed Type 1 (insulin-dependent) diabetes treated either with porcine monocomponent insulin (n = 26) or semisynthetic human monocomponent insulin (n = 26) was performed during the first 24 months after onset of diabetes. The two groups were carefully matched for age, duration of disease symptoms, initial metabolic values, islet cell antibodies and HLA-DR antigens. During the 24-month observation period there was no significant difference between the two groups in respect to the clinical course, insulin dosage, HbA1 and residual B-cell activity. No child in either group had a real remission without necessitating insulin therapy. The prevalence of insulin antibodies increased slowly and was 62% in the group treated by human insulin and 52% in the porcine insulin-treated group after 24 months. The titres were generally low and there was no statistical difference between the two groups in respect to insulin antibody formation.

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Human insulin: Much ado about one amino acid?

Cited by 41 publications

References 29 publications

Adverse Effects of Insulin Antibodies on Postprandial Plasma Glucose and Insulin Profiles in Diabetic Patients Without Immune Insulin Resistance: Implications for Intensive Insulin Regimens

Adverse Effects of Insulin Antibodies on Postprandial Plasma Glucose and Insulin Profiles in Diabetic Patients Without Immune Insulin Resistance: Implications for Intensive Insulin Regimens

Re: Hypoglycaemia (un)awareness: human vs animal insulin

Comparison of human and porcine insulin therapies in children with newly diagnosed diabetes mellitus

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