Every day, 10 million diabetics must inject insulin into their bodies, according to the American Diabetes Association. They have to prick their fingers again and again to monitor their blood sugar levels, and then determine exactly when they can eat and how much they can have. Their insulin shots have to be constantly adjusted, depending on things such as how stressed they have been or how much exercise they had that day.
And they have to be sure they are taking just the right kind and amount of insulin at just the right moment. If not, they could have a reaction leading to a coma, or even death. Failure to consistently regulate blood sugar levels with insulin increases the likelihood that diabetics will experience serious health problems later in life, including blindness, kidney failure, heart disease and damage to other vital organs.
That’s why insulin is the single most important factor for many diabetics — both the 1 million people with type 1, or insulin-dependent, diabetes and a large portion of the 15 million type-2 patients whose bodies produce some insulin, but who must supplement that insulin with an injection.
Different Insulin Types, Same Function
Insulin is a hormone found in the pancreas that is necessary to process carbohydrates, protein and fat. The goal of insulin treatment is to keep blood sugar levels as close as possible to normal levels all day long. Just how much insulin is needed a day and the type of insulin used is determined specifically for each individual based on a number of factors, including weight, how much exercise the person gets a day, what and how much they eat, and their general health.
Most of the insulin used in the in the United States is “human insulin,” according to the American Diabetes Association. Though it is synthetic, it’s “an identical copy of human islet cells,” the cells that produce insulin in the body, according to Dr. Marian Parrott, vice president of clinical affairs for the ADA.
There are also several thousand people, or about 6 percent of the U.S. population, that depend on animal insulin, according to the ADA. That insulin is made from the pancreas of pigs and cows. However, since human insulin was developed, most patients have switched to that form because it all but eliminates allergic reactions, Parrott said.
And while Parrott said that “very purified beef and pork insulins are perfectly fine,” there is simply little need for them. In fact, beef insulin is no longer being made in the United States, partly due to concerns about “mad cow disease,” and partly because the small market for this product makes it uneconomical to produce. It is uncertain how long pork insulin will remain on the market, though both beef and pork insulin can be imported from other countries with the proper authorization from the U.S. Food and Drug Administration.
Synthetic Insulin vs. Animal Insulin
There are those who believe human insulin doesn’t work as well as animal insulin, and can even be dangerous. Among the complaints, according to the National Association of Beef Insulin Users, is that it causes wide swings in blood sugar levels and can prevent users from sensing when their blood sugar drops dangerously.
While Parrott said, “There are no published papers, or research to prove that,” she admits that this could still be the case for some diabetics.
However, if there are such cases, Parrott feels certain the most likely explanation is that when the patient changed from animal to human insulin the proper dosage adjustments were not made and the person did not receive the proper medical help in making the switch.
“Millions of people have been switched to human insulin, and I’m not aware of any cases where someone was switched back because animal insulin was better,” she said.
The National Association of Beef Insulin Users disagrees, saying 100,000 people have tried synthetic insulin and could not control their diabetes with it.
And maybe there’s no proof, according to the Insulin Dependent Diabetes Trust International, because there have never been long-term trials comparing human and animal insulins.
“The evidence from people using any drug, including ‘human’ insulin, should be valued and not dismissed lightly as ‘only anecdotal.’ Those who do this fail to realize that all post-marketing collection of adverse reactions to any new drug is always anecdotal because the adverse effects are reported to doctors by their patients. The difference in the case of ‘human’ insulin is that patients have continually reported the problems to their doctors but have largely not been believed,” the IDDTI reported on its Web site.
That doesn’t change the mind of Parrott, or the official stance of the American Diabetes Association, which recommends human insulin.
Debates aside, most experts agree that the best advice for diabetics has remained the same all along: aggressively monitor the disease.
“The biggest problem we see is that people simply don’t test enough. It hurts and it’s inconvenient, so I certainly don’t fault them. It’s tough, but it’s got to be done,” Parrott said.