[Long-term therapy with human insulin. Clinical experiences].

Area of Science:

• Endocrinology
• Metabolic Disorders
• Pharmacology

Background:

• Type-1 diabetes management requires careful insulin therapy.
• Transitioning from animal-derived to human insulin is a common clinical practice.
• Optimizing insulin regimens is crucial for glycemic control and patient outcomes.

Purpose of the Study:

• To evaluate the efficacy and safety of switching from bovine to semi-synthetic human insulin in type-1 diabetics.
• To assess glycemic control, insulin requirements, and adverse events after the insulin switch.
• To investigate the impact of different insulin formulations on fasting and postprandial blood glucose levels.

Main Methods:

• A cohort of 32 type-1 diabetic patients were switched from bovine insulin (Depot-Insulin Hoechst CR) to semi-synthetic human insulin (Depot-H-Insulin Hoechst).
• Out-patient follow-up for 12 months monitored blood glucose levels (mean day, morning postprandial, fasting).
• Adjustments were made to evening insulin, including the use of NPH insulin (Basal-H-insulin Hoechst) without admixture, for patients with elevated fasting blood sugar.

Main Results:

• Mean day and morning postprandial blood sugar remained satisfactory in the cohort.
• 14 patients experienced significantly increased fasting blood sugar, which improved after adjusting evening insulin to NPH insulin.
• A slight, non-significant reduction in daily insulin requirements was observed. Hypoglycemia rates and symptoms did not significantly change.

Conclusions:

• Semi-synthetic human insulin (Depot-H-Insulin Hoechst) provides satisfactory glycemic control for type-1 diabetics previously on bovine insulin.
• Specific adjustments, such as using NPH insulin (Basal-H-insulin Hoechst) for evening injections, can effectively manage elevated fasting blood sugar.
• The switch to human insulin is safe, with no significant increase in hypoglycemia, and may lead to a slight reduction in insulin dosage.