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Related Experiment Videos

Changing from porcine to human insulin

J Everett1, D Kerr

  • 1Metabolism Unit, Royal Bournemouth General Hospital, England.

Drugs
|February 1, 1994
PubMed
Summary

Switching to human insulin may alter hypoglycemia warning symptoms for some diabetic patients. Monitoring blood glucose and adjusting dosage are crucial during this transition.

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Area of Science:

  • Endocrinology
  • Metabolic Disorders
  • Pharmacology

Background:

  • Hypoglycemia unawareness in diabetes is linked to disease duration, glycemic control, alcohol, and recurrent episodes.
  • Switching from animal-derived to human insulin generally does not increase severe hypoglycemia frequency or mortality.
  • Some patients report altered warning symptoms after changing insulin species.

Purpose of the Study:

  • To investigate the phenomenon of altered hypoglycemic warning symptoms following conversion from porcine to human insulin.
  • To provide practical recommendations for managing patients during and after insulin species conversion.

Main Methods:

  • Review of current evidence regarding insulin species conversion and its effects on hypoglycemia.
  • Clinical observations and patient-reported outcomes concerning changes in warning symptoms.

Main Results:

  • While severe hypoglycemia and mortality are not increased, a subset of patients experiences altered warning symptoms.
  • Altered symptoms may stem from reduced catecholamine response or central nervous system effects of human insulin.
  • Conversion from porcine to human insulin can change the nature of hypoglycemia warning symptoms.

Conclusions:

  • Patients should be informed about potential changes in hypoglycemia warning symptoms when switching to human insulin.
  • Recommendations include frequent blood glucose monitoring, a 10% insulin dose reduction, and discussion of treatment adjustments.
  • Reverting to animal insulin may be considered for patients experiencing persistent symptom loss; maintaining animal insulin availability is advocated.

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