Different types on Insulin

[wpaisley]

What is the difference between human insulins and modern insulins. I am on Levemir and my sister is on Insulatard. On what basis do doctors make decisions about which insulin to use. :shock:

 

[hanadr]

I suspect they prescribe their favourites.
Hana

 

[Debloubed]

how long have you and your sister been diabetic for? I was on insulatard when pregnant a long time ago, but moved to Levemir from Ultratard when they stopped making ultratard! It could be a case of what works for you both and if it ain't broke....??

 

[janabelle]

Hi,
Doctors only seem to be offering analogue insulins to newly diagnosed patients, and that has a lot to with pressure from pharmaceutical complanies. Novo Nordisk have discontinued their manufacture of animal insulins, and some human insulins. Basically Novo & Sanofi are out to corner the market, so it's all about the money :evil:

As a result Lantus & Levemir are now favoured by doctors, as many of them have no knowledge or experience of patients taking synthetic "human" long-acting insulins. This is also true of animal insulins, and many people face resistance when deciding to try animal insulin. It's a real shame that insulin choice is deminishing.

Long-acting analogues are not proven safe for children under 6, and only supposed to be used "if clearly needed" in pregnancy. Here's a link with more info http://www.rxlist.com/lantus-drug.htm#
PAGE 4.

There is no research to prove that analgue insulins are superior to human insulins. Have a look at the IDDT website for more info. http://www.Iiddtinternational.org

Was your sister diagnosed before you?
Jus

 

[kewgirl]

Hi wpaisley

Hope the following is useful.

The factors contribute to which insulin somebody uses is complex and may include:

1. Huge global pressure from insulin manufacturers particularly from human synthetic & GM
synthetic analogue insulin.

2. Financial incentives to primary care trusts for placing insulin users on a certain type of
insulin.

3. Funding of diabetes nurse specialists post by insulin manufacturers ((its often the only way
hospitals can actually employ diabetes nurse specialists but there are issues when the
manufacturers requires a certain number of patients to be on “their” type of insulin.)

4. Consultants experience / view / knowledge of insulin.

5. Funding of research / research grants for diabetes teams by insulin manufacturers.

6. NHS Policy & care pathways for treating diabetics requiring insulin.

7. The QOF (Quality & Outcomes Framework) where GP’s have to achieve certain HBA1C targets
within their diabetic population in order to receive financial rewards.

8. Published research on the various effectiveness of each individual insulin – this type of
research is often flawed as the comparison between insulin types is often only made between
human synthetic insulin & GM synthetic analogues.

I'm sure another poster will be able to add to this list!

As to the differences between the types of insulin available.

There are currently 3 Types of Insulin available in the UK. Then within each type there are a variety of insulin’s, which differ in the way they act and/or how long they last.

Animal Insulin
Human Synthetic Insulin
Genetically Modified (GM) Synthetic Analogues.

Animal insulin is extracted from the pancreases of dead pigs (Porcine Insulin) and cattle (Bovine / Beef Insulin). Following extraction they are highly purified. Animal insulin is the oldest type of insulin in use.
However……in the 1920’s to overcome the shortage of beef insulin whale (as in the large mammals that swim in the sea not the country!) insulin was also manufactured.
Examples in use today: Hypurin Porcine & Bovine Insulin, Hypurin Bovine Lente & Hypurin Bovine Protamine Zinc Insulin (PZI).

Human Synthetic Insulin is not extracted from dead humans!
It is made in the laboratory using recombinant DNA technology based on the DNA structure of insulin that human pancreases secrete.
Human insulin is grown in the lab inside common bacteria. The bacteria Escherichia coli or E-Coli is by far the most widely used type of bacterium, but yeast cells are also used.
Human synthetic insulin was developed to make insulin more available world wide.
There were concerns that the supply for insulin globally would outstrip the supply of animal insulin, which has in fact not happened.
Examples in use today: Actrapid, Humalin I, Insulatard, Insuman

GM Synthetic Analogues
The newest kids on the block! Manufactured in the laboratory by modifying the chemical structure of human synthetic insulin so that the resulting compound has different chemical properties to human synthetic insulin. Insulin analogues are therefore man made or artificial products cultivated from deactivated e-coli or bakers yeast cells.
Examples in use today: Apidra, Novorapid, Humalog, Lantus, Levemir

Insulin is like a string of beads and the way in which the beads are linked together and more significantly how they come apart denotes the mode of action for each of the respective types thus some insulin’s begin acting very quickly after injecting and other insulin’s take longer to work.

Some insulin are combined so the short acting & the longer acting component of the insulin are mixed together such as Novomix (analogue), Humalog Mix (analogue), Mixtard (human), Humalin M3 (human), Porcine 30/70 mix (animal).

Human synthetic insulin & GM analogues have differences in their amino acid structure whilst animal insulin has the nearest amino acid structure to human (non synthetic) insulin.

Sorry for the long reply!

best wishes

Txx

 

[janabelle]

Hey Kewgirl don't apologise!
Great to see you back, and back on form
Jus x

 

[wpaisley]

Thank you very much kewgirl for that information. I have just been on insulin for 3 days. I am nearly 67 and I have a very strong feeling that my insulin producing bit has finally given up the fight. I am still finding it quite emotional sticking that "pointy thing into my tummy". Who do I thank for the corrective action to stop my rising HbA1c. It was not my GP. It was sites like this that gave me the knowledge to realize I had a problem that need to be solved

 

[edith]

Kew Girl, that was really brilliant explanation.Thank you.
Might that explain why I sense I'm 'allergic' to analogue insulins and would be better to try human insulins. I use insulatard [Novo] and want to try a fast acting insulin to reduce the long high BS after meals.
Levemir made me feel terrible and Novorapid didn't work at all for 5 hours then dropped me to BS of 2 in about 1/2 hr
Edith

 

[Fallenstar]

Kew girl thanks for such a concise informative post.

I know I used to feel better and had better control on the Human synthetic insulin..and when they started to roll out the Analogues they were sold to me as the "Holy Grail" to good control and flexibility..Er right!
To be honest I did just wonder whether as this disease progressed it just became harder to control, who knows it could be the Analogues for me or a combination of things.
It seems that Human insulins are not an option anymore, I could be wrong...OR.. should we be asking for them to be a choice again??? Same with the Animal insulins, of which I have no experience.

Could I ask Kew Girl which insulins you are on ? And which you have used in the past?

Same with you Janabelle , I have read you had a very bad time on Lantus, which are you on now and have you good control on them ?

 

[janabelle]

Hi, just read your post, sorry you've had to wait so long for a reply.
Synthetic "human" insulins are very much available as are animal insulins. I'm on Hypurin Porcine Isophane (basal) in a split dose and Hypurin Porcine Neutral before meals. Feel better than I've ever felt and have better BG control than I've had since diagnosis in '89. I was on synthetic human insulins till about '98 when I changed my short-acting to Novorapid then Humalog. My basal changed to Lantus in '04 which is when all my problems began. LOL, I was given the "best thing since sliced bread" spiel, I bet they didn't tell you that pharmaceutical companies that produce these new insulins are financially supporting diabetes nursing posts- all seems a bit dodgy to me Lantus was nothing more than poison for me, it made me so ill, I had such a lousy quality of life, as I think you've read. Changing to animal insulin not ony gave me control of my diabetes, but gave me my life back. I'd been diagnosed with Fibromyalgia, depression, IBS, etc, and it was all caused by Lantus.
I've heard such garbage from docs and pharmacists alike about animal insulin being "old fashioned" or simply unavailable, but neither are true. I feel like I was being used as a gineau pig for the time I was on Lantus, and I'm much happier being on a medication that is tried, tested and been proven safe over many many years, than one which wasn't even recommended for children under 6 or pregnant women till very recently, and I have serious concerns about that, knowing how ill it made me, it's a wrong-un
Sorry to go on, I hope you push to change to another type of insulin and feel better as a result. When you see your doc, list everything and if you think there's a strong link between your problems and the insulin you're on , your doctor should take you seriously, but don't hold your breath! LOL Seriously, it's definately worth contacting the IDDT about the issues you're experiencing and they should be able to advise you about the best way to approach your doctor. Here's a link http://www.iddt.org/here-to-help/contact-us/
jus

 

[deeds24]

Type 2 in families

 

[smrfss]

Hi wpaisley

Hope the following is useful.

The factors contribute to which insulin somebody uses is complex and may include:

1. Huge global pressure from insulin manufacturers particularly from human synthetic & GM
synthetic analogue insulin.

2. Financial incentives to primary care trusts for placing insulin users on a certain type of
insulin.

3. Funding of diabetes nurse specialists post by insulin manufacturers ((its often the only way
hospitals can actually employ diabetes nurse specialists but there are issues when the
manufacturers requires a certain number of patients to be on “their” type of insulin.)

4. Consultants experience / view / knowledge of insulin.

5. Funding of research / research grants for diabetes teams by insulin manufacturers.

6. NHS Policy & care pathways for treating diabetics requiring insulin.

7. The QOF (Quality & Outcomes Framework) where GP’s have to achieve certain HBA1C targets
within their diabetic population in order to receive financial rewards.

8. Published research on the various effectiveness of each individual insulin – this type of
research is often flawed as the comparison between insulin types is often only made between
human synthetic insulin & GM synthetic analogues.

I'm sure another poster will be able to add to this list!

As to the differences between the types of insulin available.

There are currently 3 Types of Insulin available in the UK. Then within each type there are a variety of insulin’s, which differ in the way they act and/or how long they last.

Animal Insulin
Human Synthetic Insulin
Genetically Modified (GM) Synthetic Analogues.

Animal insulin is extracted from the pancreases of dead pigs (Porcine Insulin) and cattle (Bovine / Beef Insulin). Following extraction they are highly purified. Animal insulin is the oldest type of insulin in use.
However……in the 1920’s to overcome the shortage of beef insulin whale (as in the large mammals that swim in the sea not the country!) insulin was also manufactured.
Examples in use today: Hypurin Porcine & Bovine Insulin, Hypurin Bovine Lente & Hypurin Bovine Protamine Zinc Insulin (PZI).

Human Synthetic Insulin is not extracted from dead humans!
It is made in the laboratory using recombinant DNA technology based on the DNA structure of insulin that human pancreases secrete.
Human insulin is grown in the lab inside common bacteria. The bacteria Escherichia coli or E-Coli is by far the most widely used type of bacterium, but yeast cells are also used.
Human synthetic insulin was developed to make insulin more available world wide.
There were concerns that the supply for insulin globally would outstrip the supply of animal insulin, which has in fact not happened.
Examples in use today: Actrapid, Humalin I, Insulatard, Insuman

GM Synthetic Analogues
The newest kids on the block! Manufactured in the laboratory by modifying the chemical structure of human synthetic insulin so that the resulting compound has different chemical properties to human synthetic insulin. Insulin analogues are therefore man made or artificial products cultivated from deactivated e-coli or bakers yeast cells.
Examples in use today: Apidra, Novorapid, Humalog, Lantus, Levemir

Insulin is like a string of beads and the way in which the beads are linked together and more significantly how they come apart denotes the mode of action for each of the respective types thus some insulin’s begin acting very quickly after injecting and other insulin’s take longer to work.

Some insulin are combined so the short acting & the longer acting component of the insulin are mixed together such as Novomix (analogue), Humalog Mix (analogue), Mixtard (human), Humalin M3 (human), Porcine 30/70 mix (animal).

Human synthetic insulin & GM analogues have differences in their amino acid structure whilst animal insulin has the nearest amino acid structure to human (non synthetic) insulin.

Sorry for the long reply!

best wishes

Txx

Thanks brother its very good information thankyou