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October 3, 2001

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Question from Ft. Thomas, Kentucky, USA:

Due to recent events, our family had planned to participate in a blood drive at our church, and upon entering, there was a list of disqualifiers to blood donation, one of which was people with type 1 diabetes who injected insulin from (something like) 1980 to 1996. That was quite a surprise to me. Since my daughter began injecting in 1994, she was not a candidate for blood donation and was disappointed by this news (as were we all). With the tremendous crowd there, we did not take the time to ask the question “why? Can you fill us in? If the concern is the issue of the injections themselves, then why the 16 year window of time? Is the issue the type of insulin used? Is there a possibility she’ll be able to donate in the future?

Answer:

I believe the ban on blood donations from people who received injections of insulin from 1980 through the mid-1990s is in response to concerns over transmission of “Mad Cow” disease. The hypothesis is that some insulin sold in the US was manufactured from animal analogs that could be transmitting the prions carrying the disease. During a period of time, animal feed for livestock in the US and Western Europe contained the remains of sheep. A link has been found between this process of manufacturing animal feed and the transmission of Mad Cow disease. Apparently, there is a concern that fluids from some of these animals fed the suspect animal feed were used in the manufacture of insulin. Much remains to be learned about Mad Cow disease. To protect the blood supply, the FDA has recommended this and other steps to prevent possible transmission from people exposed to possible disease vectors.

DSH
Additional comments from Dr. Donough O’Brien:

I wonder if it had something to do with BSE and the use of bovine insulin. So far as I know, there is absolutely no evidence that Creutzfeldt-Jakob disease might be transmitted via this insulin. If this was the case, the exclusion from blood donation seems quite irrational.

DOB
Additional comments from Lois Schmidt Finney, diabetes dietitian:

In speaking with the managers of the Red Cross at the regional level a year or so ago, I was told that when they looked more into this, the restriction was only if you used insulin that was European-made. (i.e. Novo, not Lilly). I think this was because of the possible spread of European diseases to the US via animal insulin. So if your daughter has never used Novo beef or pork insulin and she wants to give blood, they said you need to talk with the director of nursing, not at your local Red Cross, but at a more regional one. I guess if you have a letter in hand, they will let you give blood. I know it is a hassle and not a quick solution, but you can see their point, I guess. I commend your daughter for trying to give and hope she can speak with someone who will let it happen.

LSF
Additional comments from Dr. Larry Deeb:

In the US, to protect from mad cow disease, the blood banks have disallowed people with diabetes from giving blood if they received insulin from animal source insulin where the pancreas came from Europe. Now as to a fact, all insulin the world over made from beef pancreas comes from USA beef, but I expect at the fair, they were not sorting it all out.

LD