Question:
My daughter has developed a resistance to Humulin insulin and is on Pork
based insulin now. Tests have shown she has developed some anti-bodies to
both Pork and Beef, but not as much as to Humulin.
What are our options if her anti-body development increases against the
animal based insulin?
Answer:
We wonder if somehow you've got some misinformation about antibodies against
insulin.
Antibodies to insulin that's given by injection are to be expected!
The amount of antibodies are rarely significant, and usually don't mean
anything more than a very, very minimal increase in insulin doses to
compensate for the tendency of these antibodies to inactivate the insulin
molecules.
Antibodies are most likely to be a problem in people who are now, or were
previously, on beef insulin, and somewhat less common with pork, and least
common in people who have never been on animal insulin products. Even though
semisynthetic-human insulin, such as Humulin brand, or Novolin brand, are
thought to be "identical" to human insulin, they also have the capability to
induce a bit of an antibody reaction in everyone who uses them
routinely. It's so common, in fact, that we don't do insulin antibody
testing unless there's a huge daily insulin requirement.
Rarely, there are people that develop very active antibodies that need
hundreds of units of insulin per day to overcome the antibody problems
enough to control the blood sugar level. These cases require the assistance
of a pediatric endocrinologist who is extremely knowledgeable about these
problems: really what's needed is a pediatric diabetologist.
If your daughter's doses are about the same as other kids her age and size,
it's not worth worrying about; only if she's on several hundred units per
day would it be a problem for a pediatric diabetologist to help analyze and
advise.
Original posting 5 Feb 96