GM Vs animal insulin

Choices – The Evidence
Evidence from people with diabetes
A little bit of history
Facts
Action and duration times of animal and GM ‘human’ insulins
Hypoglycaemia and loss of warnings
‘Dead in Bed Syndrome’
The concerns of patients are justified
Availability of animal insulins in the UK
Changing your insulin
What to do if your consultant refuses to change your insulin
Availability of animal insulin if admitted to hospital
Frequently asked questions
Allergic reactions to insulin

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Evidence from people with diabetes

When IDDT formed in 1994 an important task was to collect information from people with diabetes and their family carers about their experiences with synthetic ‘human’ insulin. We sent questionnaires to everyone who contacted us and analysed the first 100 we received – the questionnaires that were received subsequently were all very similar to the first 100.

We received the following information from this group of people.

Analysis showed that on average the adverse effects did not appear until 13 months after treatment with GM ‘human’ insulin began.

  • 41% – loss of warnings of hypos or ‘I function on automatic pilot’.
  • 34% – extreme tiredness or lethargy
  • 9% – sleeping all the time
  • 32% – weight increase of 1.5 stones [21 pounds] and above
  • 28% – feeling unwell all the time
  • 24% – memory loss or confusion
  • 9% – blood glucose levels dipping and peaking erratically
  • 8% – described by their families as ‘not the same person’
  • 5% – mood changes, described as difficult to live with
  • 7% – pains, especially ion the legs and joints
  • 4% – irregular or late periods

In addition to this 24% of those contacting IDDT said that their doctor was unwilling or reluctant to change their insulin to natural animal insulin and 3% told us their doctor didn’t listen or said the problems were ‘all in the mind’.

Other common statements were:

  • ‘I didn’t know that there was such a thing as animal insulin’
  • ‘I was never told there were alternatives’
  • ‘I didn’t realise that ‘human’ insulin was not derived from humans’

Patient Experience

Interview with Beverley Freeman
Bev is 39 years old and has had diabetes since she was 5 years old. She used animal insulin for about eight years and was then changed to ‘human’ insulin. After several years on GM ‘human’ insulin, she insisted on changing back to animal insulin. She now uses short acting Hypurin porcine insulin and intermediate acting Hypurin bovine isophane twice a day with an injection of porcine neutral at lunch time if necessary.

Question: Although you were quite young when you first changed to GM ‘human’ insulin, were you aware of any changes in your diabetes?

Bev: No

Question: So what made you change back to animal insulin?

Bev: I didn’t feel at all well and it was really a last resort. I seemed to be always visiting my GP and had lots of tests but he couldn’t find anything wrong with me.

Question: What do you mean when you say that you weren’t very well?

Bev: I felt constantly tired and depressed. I felt as though I had high blood sugars but they weren’t. I had problems remembering things from one minute to the next and felt unable to hold a conversation. I felt inadequate and a sort of numbness and separate from what was going on around me. On top of this I put on a lot of weight very quickly.

Question: So what happened then?

Bev: Because I had heard rumours about ‘human’ insulin affecting people differently, as a last resort I changed back to animal insulin and at this point if it hadn’t worked I don’t know what I would have done. My GP was happy to change me back to pork insulin but I know that this is not always the case for everyone who wants to change.

Question: How did things change then?

Bev: I did roughly the same doses of animal insulin and within 3 days felt a completely different person. I as able to get up in the mornings and feel awake for the first time in about 4 years! My depression went away, there was pinkness in my cheeks and I generally felt a lot fitter and healthier. My warnings of hypos came back and it was only then that I realised that they had gradually disappeared while I was on ‘human’ insulin.

Question: So what happened over a longer period?

Bev: I lost weight almost straight away and over 6 months lost nearly 3 stones [42 pounds] without dieting. My memory went back to normal or as it should be. I became more aware of what was going on around me and I felt able to include myself in this and could hold conversations with confidence again.

Question: So were there any other changes that happened that you wouldn’t have put down to altering your insulin?

Bev: Yes. When I was on ‘human’ insulin I regularly got infections, frequent tonsillitis and cuts always went septic. I had regular stomach upsets and I suffered badly with constipation. I never had regular periods. All this has changed dramatically and I have none of these problems now I am on animal insulin.

Question: Finally, have you any comments you would like to make?

Bev: Yes. I’m fully aware that ‘human’ insulin agrees with some people but for me it was crippling. I lost my teenage years to ‘human’ insulin. People must have the choice of insulins and be given the information from the experiences of others that have suffered as a result of treatment with it.

Content

HbA1c Converter

This is just to remind you that the HbA1c measurements have changed. Well, they were supposed to change everywhere but predictably this doesn't appear to be the case. Some people and some articles are still using the old measurements so it is important that we are aware of both.

Here is a table showing the current DCCT measurements, the proposed new IFCC measurements, and the average blood glucose measurements you can expect to be associated with each particular level of HbA1c

HbA1c (DCCT) Current measurement (%)

HbA1c (IFCC) Measurement from June 2011 (mmol/mol)

Average blood glucose level for this HbA1c, mmol/L

6

42

7.0 (range 5.5-8.5)

7

53

8.6 (range 6.8-10.3)

8

64

10.2 (range 8.1-12.1)

9

75

11.8 (range 9.4-13.9)

10

86

13.4 (range 10.7-15.7)

11

97

14.9 (range 12.0-17.5)

12

108

16.5 (range 13.3-19.3)

13

119

18.6 (range 14.6-21.1)