Adult; Animals; Antibodies/analysis; Antibody Formation; Diabetes Mellitus, Type 1/drug therapy/immunology/physiopathology; Female; Humans; Insulin/chemical synthesis/immunology/therapeutic use; Islets of Langerhans/physiopathology; Male; Middle Aged; Prospective Studies; Swine; Time Factors
Abstract :
[en] The levels of circulating IgG-insulin antibodies were determined in two groups of diabetic patients before and at 3-month intervals after starting insulin treatment either with monocomponent porcine insulin (n = 17) or with human semisynthetic insulin (SH) (n = 16). Patients were followed during 15.1 +/- 1.0 and 19.9 +/- 1.1 months, respectively (m +/- SEM). In addition, the quality of metabolic control and residual B-cell function were evaluated in the group under treatment with SHI. The percentage of patients who remained antibody-free after 12-21 months of treatment was 67.75% in the human insulin-treated group and only 25-43% in the one receiving porcine insulin (p less than 0.01). Moreover, insulin antibody titers, when present, were usually lower in subjects treated with human insulin. In SHI-treated patients: metabolic control was excellent during the first months of treatment as evidenced by values of mean daily blood glucose (7.3 +/- 0.6 mmol/l), M-index according to Schlichtkrull (7.4 +/- 2.4) and Hb1c (6.8 +/- 0.6%); residual B-cell function, evaluated at 3-month intervals by a circadian profile of plasma C-peptide did not decrease throughout the study; and a significant deterioration of blood glucose control occurred after 18 months of treatment, which might have been due to a less intensive supervision of the patients by the physicians and/or less careful attention by the patients themselves. This observation confirms the need for a continuous education of the patients regardless of the type of insulin used.
Disciplines :
Endocrinology, metabolism & nutrition
Author, co-author :
Luyckx, A. S.
Daubresse, J. C.
Jaminet, C.
Scheen, André ; Université de Liège - ULiège > Département des sciences cliniques > Diabétologie, nutrition et maladie métaboliques - Médecine interne générale
Lefebvre, Pierre ; Centre Hospitalier Universitaire de Liège - CHU > Diabétologie,nutrition, maladies métaboliques
Language :
English
Title :
Immunogenicity of semisynthetic human insulin in man. Long-term comparison with porcine monocomponent insulin.
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