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Related Experiment Videos

Variability of NPH insulin preparations.

M M Belmonte, E Colle, R DeBelle

    Canadian Medical Association Journal
    |January 23, 1971
    PubMed
    Summary

    Certain NPH insulin lots caused poor diabetic control, leading to hypoglycemia and hyperglycemia. Switching insulin lots or preparations improved patient outcomes, highlighting the need for better insulin quality control.

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    Area of Science:

    • Endocrinology
    • Pharmaceutical Science

    Background:

    • Juvenile diabetics on NPH insulin experienced unexplained glycemic control issues in 1968-69.
    • Symptoms included pre-breakfast glucosuria and mid-morning hypoglycemia.

    Purpose of the Study:

    • To investigate the cause of poor glycemic control in diabetic patients using specific NPH insulin lots.
    • To evaluate the impact of different insulin lots on glucose and plasma insulin levels.

    Main Methods:

    • A mail survey identified "suspect" insulin lots linked to poor diabetic control.
    • Newly diagnosed diabetics received either "suspect" or non-suspect insulins.
    • Plasma glucose and insulin levels were monitored over 24 hours.

    Main Results:

    • "Suspect" insulins caused early hypoglycemia and inadequate late-day hyperglycemia control.
    • Higher plasma insulin levels correlated with lower glucose levels.
    • Elevated free insulin in the supernatant of "suspect" insulins was detected.

    Conclusions:

    • Specific NPH insulin lots exhibited altered pharmacokinetic properties affecting glycemic control.
    • The findings underscore the critical importance of stringent quality control for insulin preparations.
    • Recommendations for improving insulin quality control procedures were proposed.

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