This study supports that with appropriate monitoring and minor adjustments, these minor pharmacokinetic differences should not pose a significant problem for glycemic control. Studies also suggest that use of human insulin may result in long term immunologic improvement in anti-insulin antibody levels in individuals previously treated with animal sources. There are no large clinical trials to support that a conversion from animal to human source insulin has resulted in any significant problems in dosage requirements or glycemic control due to changes in antibody levels in a typical patient. Hypoglycemic unawareness, defined as the lack of appropriate autonomic warning signals before development of neuroglycopenia, has been associated, but not conclusively attributed to human use. Literature cites that the causes of unawareness are multi-factorial and are most related to duration of diabetes and severity of disease.
Current evidence argues against conversion to human insulin as a cause of hypoglycemic unawareness.
This recommendation is consistent with our current TPN compounding procedure, which automatically substitutes regular human insulin in compounding all TPN orders. Iletin II U-500, a concentrated purified pork regular insulin, will be excluded from this interchange. The use of human insulin derived from Baker's yeast by recombinant DNA technology. Mokan M. Veneman T. Korytkowski M. Mitrakou A. Hypoglycemia unawareness.