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IDDT United States
Changing your insulin
The following guidelines are an extract from a talk given by Dr Laurence Gerlis at IDDT’s Annual Meeting in 1999.
· Any change of insulin, type and brand, can alter your control in the first few days or weeks and so it is important to monitor your blood glucose levels more frequently.
· Dose changes should be made in only 1 or 2 units at a time.
· Dose changes should be kept to a minimum by altering the amount of exercise and the food at the next meal to cope with the odd high blood sugar.
· There is nothing wrong with what is called conventional therapy, twice daily doses of short and longer acting insulins, and it is quite possible to achieve ‘good’ control on this regime.
· Insulin is a delicate protein and small but subtle changes in the insulin molecule, such as the difference between the insulin molecule in pork and ‘human’, can affect diabetic control in some patients.
· Both doctors and patients tend to raise the dose of insulin and rarely lower it. For example, if the morning blood sugars are high as a result of the body’s reaction to a hypo in the night, then raising the insulin dose will only make this situation worse. This leads to a vicious circle of increasing insulin doses to cope with highs, leading to more hypos and so it goes on.
Frequently asked questions:
‘What is the difference between pork and beef insulin?’
Answer: Generally beef insulin is slower acting with a smoother peak of activity than pork insulin.
‘What is the difference in the activity and duration of action between animal and ‘human’ insulins?’
Answer: Generally ‘human’ insulins are faster acting, have a more aggressive action and are of shorter duration than animal insulins.
‘Is there any difference in the purity of animal and ‘human’ insulins?
Answer: All insulins are highly purified and are equally pure.
‘If ‘human’ insulin is the cause of my problems and I change to animal insulin, how quickly can I expect to feel better?’
Answer: This seems to vary in different people. In some people some of the symptoms disappear in a matter of days with the other symptoms regressing over the following weeks or months. In other people the symptoms gradually disappear over weeks and months. Some people feel that changing to animal insulin simply stops the decline in their health. You should try the new insulin for at least 6 months.
‘What will happen to my blood sugars during the changeover period?’
Answer: They may well be erratic for a few days but you should always monitor your blood glucose levels closely. Some people find that their blood sugars are raised for the first few days, so if you increase your insulin to cope with this, be prepared for your blood sugar to drop and the risk of a hypo. 'They may be erratic for a few days but you should always monitor your blood glucose levels closely when changing insulins.'
‘I have heard that beef insulin can cause allergic skin reactions, is this true?’
Answer: This was a problem with the early beef insulin before it was highly purified. Now that all insulins are highly purified allergic skin reactions are far less common but any insulin species, including ‘human’, may cause skin reactions in some people. If this is the case, then a different insulin species should be tried.
‘Is there any risk of BSE or nvCJD from using beef insulin?’
Answer: Since 1989 beef insulin has been extracted from the pancreases of US cattle and NOT cattle from the UK. Beef insulin is highly purified and the risk is extremely minimal but as there is no test available to prove that there are no prions present, it is impossible to prove that there is absolutely no risk. The UK Department of Health has issued a statement to say that there was no reason to stop using beef medicinal products, including beef insulin.
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