I am a 48 year old female, have had diabetes for almost 22 years, and I am currently taking seven injections daily (Humulin ZN [Ultralente] and Humulin S [Regular] mixed before breakfast, five injections of Humulin S during the day, and an injection of Humulin ZN before bedtime). I have also tried an insulin pump for three and a half years which proved unsuccessful.

As my diabetes is brittle with the complication of autonomic neuropathy (and I have spent many months in hospital over the years), my Consultant put my name forward to take part in the UK trials of insulin glargine. However, today at my appointment I was given the letter from the manufacturer to read and was quite alarmed to discover some of the side effects of the product. The major one that concerns me is the possible cause of cancer or even death in severe cases of allergic reaction.

Although I have visited many web sites, I am unable to find anything listed so severe under possible side effects. I know that this insulin has been available in the US for some time. Has anyone suffered anything so severe?

I am puzzled by your query about Lantus (insulin glargine). It does not seem to have any special problems compared to other insulin products, to my knowledge.

You should discuss your concerns directly with your own diabetes specialist who knows your own case rather well. Your specialist can also help review the potential benefits against any risks for using Lantus. In the United States, many many folks have been transferred to Lantus with good results and, so far, there has not been any special high risks that were not expected.

There are some potentials for allergic reactions to any insulin product, and Lantus is not more allergenic than others. Lantus can cause some local irritation, but this is thought to be related to its acid pH not to an allergic phenomenon. There is a theoretical risk because of cross reactivity with growth hormone related receptors in animals, but this also has not been seen in any clinical case with humans, so far. Whether or not this would occur in the future with extended use is not known.

The immediate benefit of improved and more reproducible control with Lantus compared to other insulins would seem to outweigh only theoretical dangers with using Lantus for most folks with diabetes — if they were being changed to try to improve glycemic control.

SB