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Intermediate-acting insulin preparations: NPH and lente

T Deckert

    Diabetes Care
    |September 1, 1980
    PubMed
    Summary

    Neutral Protamine Hagedorn (NPH) and lente insulins exhibit distinct physicochemical properties and durations of action. NPH insulin offers greater flexibility in mixing with regular insulin compared to lente insulin.

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    Area of Science:

    • Endocrinology
    • Pharmacology

    Background:

    • Neutral Protamine Hagedorn (NPH) and lente insulins are commonly used intermediate-acting insulin formulations.
    • Differences in their physicochemical properties, such as crystal size and species composition, influence their clinical behavior.

    Purpose of the Study:

    • To compare the physicochemical characteristics, duration of action, and mixing compatibility of NPH and lente insulins.
    • To evaluate potential differences in side effects, specifically lipoatrophy and immunogenicity, between highly purified porcine NPH and lente insulin preparations.

    Main Methods:

    • Physicochemical analysis of NPH and lente insulin formulations.
    • Assessment of the duration of hypoglycemic effect in vivo.
    • Evaluation of the stability of mixtures with neutral insulin solutions.
    • Comparative analysis of side effects (lipoatrophy, immunogenicity) of highly purified insulin preparations.

    Main Results:

    • Lente insulin, containing beef insulin, has a longer duration of action (>24 h) than NPH insulin (≤24 h) at equivalent doses.
    • NPH insulin can be stably mixed with regular insulin, whereas lente insulin cannot without altering the effect profile.
    • Highly purified porcine NPH and Monotard (lente-like porcine insulin) showed similar side effect profiles.
    • Highly purified lente insulin (with beef insulin) appeared more immunogenic than highly purified porcine NPH insulin.

    Conclusions:

    • NPH and lente insulins possess distinct pharmacokinetic and physicochemical profiles.
    • NPH insulin provides superior flexibility for combination therapy with rapid-acting insulins.
    • Species composition, particularly the inclusion of beef insulin in lente preparations, may influence immunogenicity.

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