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Correlation between HbA1c, purified insulins, diabetic control, and insulin antibodies in diabetic children
Insights
Children with better diabetic control had lower insulin antibody levels. Purified porcine insulin use was linked to reduced antibody concentrations compared to non-purified bovine insulin in juvenile diabetes patients.
Area of Science:
- Immunology
- Endocrinology
- Pediatrics
Background:
- Insulin antibodies can form in patients with juvenile diabetes (Type 1 diabetes).
- The type and purity of insulin used for treatment may influence antibody formation.
- Insulin antibody levels can potentially impact glycemic control.
Purpose of the Study:
- To investigate the relationship between insulin antibody levels, diabetic control, and insulin treatment types in children with juvenile diabetes.
- To compare insulin antibody concentrations in children treated with purified porcine insulin versus non-purified bovine insulin.
Main Methods:
- Sera from 38 children with juvenile diabetes were analyzed for insulin antibodies using specific and non-specific radioimmunoassays.
- Insulin antibody levels were correlated with diabetic control metrics (e.g., HbA1c) and insulin treatment history.
- Different insulin preparations (purified porcine, bovine insulin NPH, non-purified) were assessed for their association with antibody levels.
Main Results:
- A strong correlation was observed between antibody concentrations measured by different methods.
- Children with better diabetic control exhibited significantly lower insulin antibody levels.
- Patients treated with purified porcine insulin showed significantly lower antibody levels compared to those on non-purified bovine insulin.
- A positive correlation was found between HbA1c levels and insulin antibody concentrations.
Conclusions:
- Diabetic control is inversely related to insulin antibody levels in children with juvenile diabetes.
- Purified porcine insulin appears to induce lower insulin antibody responses than non-purified bovine insulin.
- Monitoring insulin antibodies may be relevant for managing juvenile diabetes, particularly concerning insulin treatment efficacy.
Abstract:
Insulin antibodies were determined in sera from 38 children diagnosed as having juvenile diabetes for a duration of 0.7-15.2 years (median = 4.9 years). 8 children were treated with purified porcine insulins from the beginning of their disease, 16 children with bovine insulin NPH alone, and 14 children with non-purified, of whom 9 were later transferred to purified insulins. Serum insulin antibodies were measured by non-specific and specific methods using beef (B) and pork (P) antigens as described by Welborne and Sebriakova, respectively. 12/38 children had insulin binding levels similar to those of normal children, irrespective of the type of insulin used. The concentration of antibodies using radiolabelled B or P insulins as antigens were strongly correlated, by both the non-specific (p less than 0.01) and the specific (p less than 0.01) methods. Children with better score for diabetic control had significantly lower levels of insulin antibodies against B (p less than 0.05) and P (p less than 0.05) than those with poor diabetic control. There was also a significant positive correlation between mean HbA1c concentration and both B and P mean insulin antibody concentration (p less than 0.01). Finally, patients treated with purified porcine insulin had significantly lower levels of antibodies than patients with non-purified bovine insulin (p less than 0.05).