Biosynthetic Human Insulin: Progress and Prospects

The biologic effect of biosynthetic human insulin (BHI) has been assessed in both healthy volunteers 1 -8 and diabetic subjects,'' as reported elsewhere in this issue of DIABETES CARE. In comparative studies in the same subjects, the plasma glucose lowering action of BHI is similar to that of purified pork insulin (PPI).' The subtle differences in magnitude of decline of plasma glucose seen in several of these studies may or may not reflect real differences in potency of these insulins. The dose-response curves (admittedly only at submaximal doses) for glucose disposal in five healthy subjects were similar for both BHI and PPI. Moreover, the amount of insulin needed to maintain euglycemia in insulin-requiring diabetic subjects, studied with a glucose controlled insulin infusion system (GCIIS), was generally the same with BHI and PPI.--" Only in one report was there a slight reduction (less than 10%) in insulin requirement on the GCIIS with BHI compared to PPI, with this difference primarily accounted for by the amount of insulin required for disposal of glucose following breakfast. The other two reports did not detect such a difference.'

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