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March 23, 2004

Complications

Question from Anoka, Minnesote, USA:

I have been reading many of the questions submitted regarding rapid (without warning) low blood sugars, dead in bed syndrome, and other problems related to the adverse effects of "human insulin" reported by many type 1 diabetics. I was wondering why the advice your team has given to these people has never mentioned this could by the culprit? All the people I have read about who experienced these awful complications, have gone back to managing their disease just fine when going back on animal insulin, which has unfortunately become an insulin of the past. My 29 year old brother died in bed of these compications on 10/31/03. He had the disease for 26 years. His problems began when he was switched to human insulin when it became the "new and improved" insulin, only there wasn't anything wrong with the insulin he was taking from the onset in 1973. Unfortunately, we were never told that it could be the insulin deteriorating his life over the years. We never suspected the drug we thought was keeping him alive was actually killing him. I realize there is controversy over this subject, but we should have been told of the options. It's too late for my brother and my family, but these other families need to know.

Answer:

Please accept our condolences on the loss of your brother.

In ‘Human’ insulin versus animal insulin in people with diabetes mellitus, researchers sought to “…assess the effects of different insulin species by evaluating their efficacy (in particular glycaemic control) and adverse effects profile (mainly hypoglycaemia)” because of reports from physicians and patients about a perceived change in hypoglycaemia awareness. The researchers concluded that “No significant differences in metabolic control or hypoglycaemic episodes between various insulin species could be elucidated” and that “A comparison of the effects of human and animal insulin as well as of the adverse reaction profile did not show clinically relevant differences.” They also noted, however, that “many patient-oriented outcomes like health-related quality of life or diabetes complications and mortality were never investigated in high-quality randomised clinical trials.”

Both Novo Nordisk and Eli Lilly, the two largest insulin producers, are no longer producing animal-sourced insulins. A quick review of their web sites shows only human insulin produced via recombinant DNA means. As such, anyone who requires insulin today will be using human insulin.

For patients who feel that they do better on animal insulin, the FDA page on Frequently Asked Questions about Importing Beef Insulin for Personal Use may be helpful.

Also, our page about The Dead in Bed Syndrome offers some insight into this tragic though rare occurrence.

JSH