A comparison of the effects of human and animal insulin as well as of the adverse reaction profile did not show clinically relevant differences. Many patient-oriented outcomes like health-related quality of life or diabetes complications and mortality were never investigated in high-quality randomised clinical trials. The story of the introduction of human insulin might be repeated by contemporary launching campaigns to introduce pharmaceutical and technological innovations that are not backed up by sufficient proof of their advantages and safety.
Human ultralente insulin: a comparison with porcine lente insulin as a twice-daily insulin in insulin-dependent diabetic patients with fasting hyperglycaemia.
Six C-peptide-deficient diabetic patients, selected because of raised fasting blood glucose concentrations, participated in a randomised cross-over trial comparing twice-daily porcine soluble plus human ultralente with porcine soluble plus porcine lente insulins. As out-patients, overall mean blood glucose concentrations before and after breakfast were significantly lower during human ultralente therapy (7.2 +/- 0.8 vs 12.0 +/- 1.3, 11.1 +/- 1.0 vs 14.3 +/- 1.0 mmol/l, p less than 0.05), but were unchanged for the rest of the day. During overnight in-patient metabolic profiles a nadir in blood glucose occurred between 2-4 am with both insulin regimens (5.2 +/- 0.9 mmol/l ultralente, 6.5 +/- 1.3 mmol/l lente). Mean fasting and post-breakfast blood glucose levels were significantly lower with human ultralente as were fasting concentrations of glycerol and non-esterified fatty acids (p less than 0.05). Patients with poor overnight metabolic control and raised fasting blood glucose concentrations may benefit from human ultralente insulin, used as part of their twice-daily insulin regimen.