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December 2, 2000

Insulin

Question from Boothwyn, Pennsylvania, USA:

I am 41 years old and have had diabetes since age four. I was on the Lilly beef/pork insulin [brand name: Iletin I] until last spring when I switched to semi-synthetic human insulin as a result of Lilly's decision to discontinue the beef/pork insulin. I am in good control with HbA1cs 5.5 - 6.4 over the past seven years. I had been given clearance by my doctor to give blood, which I had done periodically. The last time I went to give blood, they added a new question about whether you had taken bovine insulin at any time since 1980. Since I had, they would not allow me to give blood. They said there was a risk the blood was infected with Mad Cow Disease. I explained the insulin had been manufactured by Lilly and bought in US pharmacies, but that didn't matter to them. They said Lilly was unable to certify to them the source of their beef insulin. Have there been any cases of mad cow transmitted through Lilly's Iletin I? Have there been any cases of Mad Cow Disease in the US? Did Lilly use insulin from non-US cows in making Iletin I? Is there some test or something I should have to make sure I don't have Mad Cow Disease?

Answer:

Lilly only uses US pancreas.
No madcow in US.
Blood folks are just too careful.

You are okay.

LD

[Editor’s comment: Obviously, there’s no way that we can say with certainty that a risk is zero. The risk in the US of developing CJD from beef insulin is currently thought to be exceedingly small.

Here’s some reading material that the interested reader might wish to review:

Prions and blood products
Human prion diseases
Annotation: vCJD – predicting the future?
FDA Calls Bovine-Based Vaccines Currently Safe
Policy understanding of science, public trust and the BSE-CJD crisis
Mad cows and Englishmen
Species-barrier-independent prion replication in apparently resistant species (full text)

Natural and experimental oral infection of nonhuman primates by bovine spongiform encephalopathy agents (full text)

WWQ]