Human compared with animal insulin

StudyPopulationInterventionOutcomesResultsCommentsDesignEL
Richter and Neises, 20021352156 participants in 45 RCTs
Patients with diabetes, all ages
Human insulin
versus
animal insulin
Duration of trials at least 1 month
HbA1c
HbA1
Fasting plasma glucose
Insulin dosage
Insulin antibodies
No significant differences in metabolic control or hypoglycaemic episodes between various insulin species could be elucidated
Insulin dosage and insulin antibodies did not show relevant dissimilarities
A comparison of the effects of human and animal insulin as well of the adverse reaction profile did not show clinically relevant differences
Many patient-oriented outcomes such as health-related quality of life, diabetes complications or mortality have never been investigated in high-quality RCTs
Systematic review of RCTsIa
Greene et al, 198313614 children with type 1 diabetes
Mean ages: 13.2 ± 1.8 and 13.7 ± 2.5 years
Setting: UK single centre
Human monocomponent insulin zinc suspension (Monotard) and soluble insulin (Actrapid insulin)
versus
porcine monocomponent insulin zinc suspension (Monotard) and soluble insulin (Actrapid insulin)
Duration of trial 3 months
  1. HbA1
  2. Fasting plasma glucose
  3. Insulin dosage
  4. Adverse effects
  1. 11.9 ± 2.5% vs. 11.5 ± 3.8%
  2. 7.8 ± 4.9 vs. 8.3 ± 4.6 mmol/l
  3. 48 ± 18 vs. 45 ± 18 units/day
  4. 3 drop-outs
Randomisation procedure: data missing
Allocation concealment: unclear
No significant difference between the two groups was seen overall
RCT
Double blind crossover study
Ib
Heding et al, 1984137135 newly diagnosed children with type 1 diabetes
Setting: Denmark multicentre
Semisynthetic human insulin
versus
purified porcine insulin
Duration of trial 12 months
Insulin antibodies78% vs. 100%Randomisation procedure: data missing
Allocation concealment: unclear
RCT
Parallel
Ib
Mann et al, 198313821 children with type 1 diabetes
Mean age 12/11 years (human/animal insulin)
Setting: UK single centre
Semisynthetic human insulin
versus
purified porcine insulin
Duration of trial 4 months
  1. HbA1
  2. Fasting plasma glucose
  3. Insulin dosage
  4. Adverse effects
  1. 14.4 ± 1.8% vs. 13.8 ± 1.7%
  2. 12.0 ± 2.1 vs. 11.0 ± 2.4 mmol/l
  3. 37 ± 10 vs. 37 ± 13 units/day
  4. 3 drop-outs vs. 1 drop-out
Randomisation procedure: data missing
Allocation concealment: unclear
RCT
Double blind crossover study
Ib
Marshall et al, 1988139100 newly diagnosed children with type 1 diabetes
Mean age 9/9 years (human/animal insulin)
Setting: Denmark multicentre
Semisynthetic human insulin
versus
purified porcine insulin
Duration of trial 24 months
Adverse effects12 vs. 13 drop-outsRandomisation procedure: adequate
Allocation concealment: unclear
RCT ParallelIb

From: Evidence tables

Cover of Type 1 Diabetes
Type 1 Diabetes: Diagnosis and Management of Type 1 Diabetes in Children and Young People.
NICE Clinical Guidelines, No. 15.2.
National Collaborating Centre for Women's and Children's Health (UK).
London: RCOG Press; 2004 Sep.
Copyright © 2004, National Collaborating Centre for Women’s and Children’s Health.

Apart from any fair dealing for the purposes of research or private study, criticism or review, as permitted under the Copyright, Designs and Patents Act, 1988, no part of this publication may be reproduced, stored or transmitted in any form or by any means, without the prior written permission of the publisher or, in the case of reprographic reproduction, in accordance with the terms of licences issued by the Copyright Licensing Agency in the UK. Enquiries concerning reproduction outside the terms stated here should be sent to the publisher at the UK address printed on this page.

The use of registered names, trademarks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant laws and regulations and therefore for general use.

The rights of National Collaborating Centre for Women’s and Children’s Health to be identified as Author of this work have been asserted by them in accordance with the Copyright, Designs and Patents Act, 1988.

PubMed Health. A service of the National Library of Medicine, National Institutes of Health.