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[Human insulin and hypoglycemia].

A Pernet1, W Berger

  • 1Unité de diabétologie, Hôpital de la Tour, Meyrin-Genève.

Schweizerische Rundschau Fur Medizin Praxis = Revue Suisse De Medecine Praxis
|October 9, 1990
PubMed
Summary
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Switching diabetic patients to human insulin may alter hypoglycemia symptoms, favoring neuroglycopenia over typical signs like hunger. Current evidence suggests caution, recommending against switching patients already on animal-based insulin.

Area of Science:

  • Endocrinology
  • Metabolic Disorders
  • Pharmacology

Context:

  • Transitioning diabetic patients from animal-derived to human insulin formulations.
  • Observed alterations in the symptomatic presentation of hypoglycemia.
  • Potential impact on counterregulatory hormonal responses.

Purpose:

  • To analyze the shift in hypoglycemic symptom patterns following human insulin initiation.
  • To evaluate the implications of these changes for patient management and safety.
  • To provide recommendations regarding insulin therapy transitions.

Summary:

  • A subset of patients (8-36%) exhibit a shift from adrenergic (e.g., hunger, sweating) to neuroglycopenic hypoglycemic symptoms after switching to human insulin.
  • This switch may also be associated with a diminished adrenergic counterregulatory response to low blood glucose.

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  • Confounding factors include intensive insulin therapy, long diabetes duration, and autonomic neuropathy.

    • Impact:

    • Suggests human insulin may be better suited for newly diagnosed patients who can learn new symptom patterns.
    • Recommends against transferring patients currently on porcine insulin to human insulin.
    • Highlights the need for prospective studies to definitively clarify the risk of severe hypoglycemia with human insulin.