Further evidence for a high incidence of nocturnal hypoglycaemia in IDDM: no effect of dose for dose transfer between human and porcine insulins
✍ Scribed by George, E.; Bedford, C.; Peacey, S.R.; Hardisty, C.A.; Heller, S.R.
- Publisher
- John Wiley and Sons
- Year
- 1997
- Tongue
- English
- Weight
- 147 KB
- Volume
- 14
- Category
- Article
- ISSN
- 0742-3071
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✦ Synopsis
We tested the hypothesis that transfer from porcine to human insulin causes a fall in nocturnal blood glucose and an increase in the frequency of hypoglycaemic episodes. Twenty IDDM patients (age 19-55, duration 3-36 years) used Velosulin and Insulatard twice daily for 12 weeks, double-blinded to species (human (H) or porcine (P)) in a randomized crossover study. Species was changed after 4 weeks' run-in and 4 weeks later, with insulin doses unchanged on transfer. Ten patients underwent each sequence (H/P/H or P/H/P) and were admitted on the first and eighth night after transfer for hourly blood glucose measurement (22.00-07.00). Biochemical hypoglycaemia (Ͻ3.5 mmol l -1 ) was observed on 39 of the 80 patient-nights studied (48.75 %). The number of episodes were similar during each night (H1 8, H8 10, P1 10, P8 11, p = 0.83). Total reported symptomatic episodes (H 51 vs P 73, p = 0.85), total HbA 1 (H 9.8 ± 0.3 %, P 10.0 ± 0.3 %, p = 0.32) and daily insulin doses (H 0.63 ± 0.04 units kg -1 day -1 vs P 0.63 ± 0.05 units kg -1 day -1 , p = 0.54) were not different. Despite an apparent fall in blood glucose levels from night 1 to 8 on transfer to human (AUC 82.3 ± 7.8 vs 61.4 ± 5.3 mmol.h l -1 , p Ͻ 0.05) but not porcine insulin (AUC 70.7 ± 7.2 vs 70.1 ± 7.5 mmol.h l -1 , p = 0.74), there was no difference when all 4 nights were considered together (p = 0.30). We conclude that dose for dose transfer to human insulin does not increase numbers of episodes of nocturnal or reported hypoglycaemia.