The clinical significance of highly purified pig-insulin preparations

Abstract

Side effects of insulin treatment (red spots at the injection site, lipoatrophy and insulin antibody formation) are primary related to the purity and the species of the insulin preparations used in treatment. To evaluate the clinical significance of these factors daily insulin requirements were registered in 1685 protamine insulin treated eases; red spots and lip| recorded in 500 NPI-I insulin treated patients and insulin antibodies determined in 173 patients. 51 of the patients were treated for more than 12 months with highly purified porcine insulin (proinsulin contamination <0.5 ram|174 96 patients were treated for 1-4 years with porcine NPH insulin (proinsulin contamination 12-13 ram|174 and most of the remaining patients have been treated with mixed porcine-bovine insulin preparations in earlier periods. It was shown that high purification of porcine NPH insulin is of importance in reducing insulin dose, lip| and insulin binding capacity of serum. Thus insulin antibodies could be demonstrated in only 3 of 51 patients after 1 ~ year of treatment with highly purified porcine NPI4 insulin. None of these patients developed red spots at the injection si~e and only one patient developed a small shallow depression of the subcutaneous tissue on one thigh. The daily insulin requirement was significantly lower when compared with the insulin requirement of a porcine NPI-I insulin treated control group.

Prognosis of diabetics with diabetes onset before the age of thirtyone

“…Since 1950 Danish NPH-insulin has been used in nearly all patients, which means rather highly purified, glucagon free, 85% porcine-15% bovine insulin, and since 1949 no case of insulin resistance has been seen at the Hospital. After 1965 we gradually changed to the use of pure porcine NPH-insulin, a change which influenced the formation of insulin antibodies and thereby the daily dose [3]. The insulin requirements of the last day of hospitalization was recorded, when the patient was on proper diet, without Somogyi-phenomenon and with physical activity imitating the usual habits.…”

“…The prognostic importance of contact between the patient and the specialist unit was studied [1] by comparing the survival of diabetics who had a varying frequency of contact with the Steno Memorial Hospital during the first twenty years of diabetes, [2] by comparing the influence of domicile upon the survival of diabetics referred to the Steno Memorial Hospital within their first fifteen years of disease and [3] by comparing the survival in diabetics who had been referred to the Steno Memorial Hospital after a diabetes duration of 0-15, 16-25, and more than 25 years.…”

Use of insulin in diabetes: a century of treatment

“…17 TABLE. Timeline of insulin development [6][7][8][9][10][11][12][13] Date/year Development of insulin…”

“…This insulin was called a monocomponent by Nova and single-peak insulin by Eli Lilly. 10 Purification had reduced the incidence of hypersensitivity reaction and lipoatrophy by insulin.…”

Evolution of Insulin Development: Focus on Key Parameters

“…This review will discuss the Although initial preparations of insulin from animal sources were successful in treating patients with diabetes, these early insulins had highly variable efficacy. Impurities in animal insulin products were associated with side effects such as insulin allergy and lipoatrophy, prompting researchers to develop methods for insulin purification [1]. Therefore, synthetic and recombinant "human" insulins were developed to enhance insulin purity as well as reproducibility of response.…”