Comparative study of NPH human insulin (recombinant DNA) and pork insulin in diabetic subjects: preliminary report

Insulins

More than ever before in the history of diabetes therapy, patients and health care providers have the necessary pharmacologic tools available to achieve near-normal blood glucose control. Achievement of this goal, however, requires an in-depth knowledge of the pharmacology and limitations of the currently available insulins. A willingness to try new strategies combined with a creative approach to each patient will result in optimal diabetes management. Continued advances in the development of insulin analogues and investigation into alternative routes of insulin delivery are likely to expand therapeutic options in the near future. Such developments will continue to improve the quality of life and health of patients with diabetes.

A comparison of biosynthetic human insulin with porcine insulin in the blood glucose control of diabetic pregnancy

Fifty insulin-dependent pregnant diabetic women were treated from presentation at the antenatal clinic with a regimen of either porcine or biosynthetic human soluble and isophane insulins. Blood glucose values, glycosylated haemoglobin, insulin requirements and outcome of pregnancy were compared in the two groups of patients. No difference was noted in blood glucose control, birth weight or neonatal complications. In the group treated with human insulin, fasting blood glucose could only be controlled by significantly greater doses of human isophane insulin injected before the evening meal. Furthermore, in two cases adequate glycaemic control required the injection of the evening human isophane insulin to be delayed until bedtime.

Human (recombinant DNA) and porcine NPH insulins are unequally effective in diabetic patients. A comparative study using continuous blood glucose monitoring

The hypoglycemic activities of NPH biosynthetic human and pork insulins were compared in eight insulin-dependent diabetic patients using continuous blood glucose monitoring. After an overnight normalization of blood glucose levels, either human or pork NPH were injected subcutaneously in random order. Blood glucose was continuously recorded during 9.5 h while patients were consuming their usual diet. After NPH biosynthetic human insulin, blood glucose levels from the 2nd to the 9th h post-injection were lower as well as the glycemic nadir. The area under the curve was smaller after human than after pork insulin. But, in the last half-hour of the experiment, blood glucose was falling after pork insulin, while it was rising after human insulin. Under the conditions of this study, our results demonstrate that NPH biosynthetic human insulin may be more effective than NPH pork insulin, due to more rapid subcutaneous absorption but its duration is shorter than after porcine NPH insulin. These data may be of importance in the treatment of insulin-dependent diabetes mellitus.