Hypoglycaemia: no difference between human and animal derived insulins
Clinical bottom line (level 4)
In insulin using diabetics, taking human or animal-derived insulins did not alter the likelihood of reporting hypoglycaemia
In insulin taking diabetics, about one third experienced symptoms of hypoglycaemia at least weekly
Klein et al:
Prospective cohort study
for confounding factors,
validated in an independent set of patients.
Setting: 11 county area in USA
insulin-dependent diabetes mellitus (IDDM) with onset <30y
patients taking none, or a mix of insulin derivations at either 4 or 10 year review
multivariate linear regression
maximum 10 years
hypoglycaemic events more than once per week
combined human/animal insulin users
frequency of hypoglycaemic reactions
||time to outcome
||number of patients/total number
|hypoglycaemic events more than once per week
|frequency of hypoglycaemic reactions
- There was no difference between the human and animal insulin users.
- Decreasing body mass index was a prognostic factor for increasing frequency of hypoglycaemic reactions (OR 0.94; 95% CI: 0.91 to 0.97), as was decreasing glycosylated haemoglobin (OR 0.88; 95% CI: 0.81 to 0.96).
- Episodes of hypoglycaemia based on recollections over the previous year.
- The population in the tables n=740, wheras the text details 741 patients. This difference is unlikely to materially affect the results.
- This study is largely of historical interest, as the vast majority of insulin-users are on human -derived insulins.
Contributor: Bob Phillips and Clare Wotton,
Risk of hypoglycaemia in users of human insulin.
Reviewer: Wai-Lam Chan
||insulin using diabetics
|Intervention or Exposure
||risk of hypoglycaemia