Comparison of porcine insulin and human insulin (Novo) using the glucose-controlled insulin infusion system, glucose-insulin dose-response curves, and the outpatient effectiveness of human insulin (Novo) in insulin-dependent diabetes

Abstract

The usefulness of human insulin (Novo) in the treatment of diabetes was studied in eight insulin-dependent diabetic patients. Evaluation was carried out through three methods: (1) glucose-controlled insulin infusion system on two separate days during the patients' ingestion of mixed meals; (2) euglycemic clamp method; and (3) evaluation of patients for 3 mo using short- and intermediate-acting insulins. Employing the glucose-controlled insulin infusion system resulted in mean daily insulin requirements of 84 +/- 9 U and 85 +/- 6 U SEM for porcine and human insulin, respectively (P = NS). Plasma glucose levels attained during the euglycemic clamp were 96 +/- 3 mg/dl. At each insulin infusion rate, the steady-state glucose infusion rates for porcine insulin were 1.12 +/- 0.22, 1.90 +/- 0.58, 4.28 +/- 0.61, and 9.37 +/- 0.66 mg/kg/min compared with 1.27 +/- 0.42, 2.38 +/- 0.20, 4.25 +/- 0.43, and 8.87 +/- 0.67 mg/kg/min for human insulin. No complications of either insulin preparation were observed in the 3-mo patient evaluation. Human insulin was associated with lower levels of circulating insulin antibody (P less than 0.03). In addition, hemoglobin A1c levels decreased from 8.4 to 6.9% (P less than 0.035), and normal hemoglobin A1c levels were maintained in patients using portable insulin infusion pumps.