The clinical significance of highly purified pig-insulin preparations

Abstract

Side effects of insulin treatment (red spots at the injection site, lipoatrophy and insulin antibody formation) are primary related to the purity and the species of the insulin preparations used in treatment. To evaluate the clinical significance of these factors daily insulin requirements were registered in 1685 protamine insulin treated cases; red spots and lipoatrophy recorded in 500 NPH insulin treated patients and insulin antibodies determined in 173 patients. 51 of the patients were treated for more than 12 months with highly purified porcine insulin (proinsulin contamination <0.5 mmol/mol). 96 patients were treated for 1-4 years with porcine NPH insulin (proinsulin contamination 12-13 mmol/mol), and most of the remaining patients have been treated with mixed porcine-bovine insulin preparations in earlier periods. It was shown that high purification of porcine NPH insulin is of importance in reducing insulin dose, lipoatrophy and insulin binding capacity of serum. Thus insulin antibodies could be demonstrated in only 3 of 51 patients after 11/2 year of treatment with highly purified porcine NPH insulin. None of these patients developed red spots at the injection site and only one patient developed a small shallow depression of the subcutaneous tissue on one thigh. The daily insulin requirement was significantly lower when compared with the insulin requirement of a porcine NPH insulin treated control group. © 1974 Springer-Verlag.