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Side effects of insulin injections revealed

Date: 10/03/99

By JULIE ROBOTHAM, Medical Writer, and agencies

Up to 40,000 Australian diabetics may unwittingly be suffering adverse side effects from taking genetically engineered synthetic insulin, suggests British research completed six years ago which has just been revealed.

But the availability of animal-derived alternatives, which doctors agree suit some patients better, is about to be further limited by the withdrawal of the main brand of cattle-derived "beef" insulin from the local market. Novo Nordisk will withdraw from the market in July, citing commercial reasons.

"Pork" insulin was withdrawn in 1990, though the firm makes it available to some people on "compassionate grounds".

The UK research, commissioned by the British Diabetics Association, has found up to 10 per cent of diabetes patients may suffer side effects - the most serious of which is a dangerous loss of the ability to recognise they are about to lose consciousness - as a result of taking synthetic "human" insulin. This has almost completely superseded insulins derived from pigs or cows. The research was based on studies of 3,000 diabetics after they switched to human insulin.

Injected daily, insulin replaces a hormone, usually produced by the pancreas, for people whose bodies do not manufacture it naturally. Without it, diabetes is potentially fatal.

The manager of educational services for the NSW branch of Diabetes Australia, Ms Bernadette Lowther, said: "The majority of people have no problems with the transfer to human insulin. For a small minority we hear reports that the quality of life was impaired ..."

Supply changes for beef insulin, which is understood to be used by about 3,000 of Australia's more than 400,000 diagnosed diabetics, would affect the elderly the most, Ms Lowther said. Several concerned doctors had contacted the organisation.

"This is a significant issue for older people who have controlled their diabetes very well on one injection a day," she said. The tendency was for people to need to inject more frequently - up to four times a day - when they switched to human insulin.

The medical director of Novo Nordisk, Dr John Miller, said there was no evidence that either form of insulin was superior to the other. But human insulin was cheaper and safer to produce as it was guaranteed free of animal viruses.

The professor of diabetes at Melbourne's Monash University, Professor Paul Zimmet, said the number of people who genuinely needed animal insulin was "minuscule". However, switching drugs could cause problems because the volume of synthetic insulin required was usually lower, which not all doctors understood.

Mr Ron Walker, 67, of Allawah, says the two years he spent on human insulin were "the most disastrous period of my life". He used the synthetic drug around 1990 when pork insulin was first withdrawn. He lost consciousness several times without warning and eventually insisted on using beef insulin.

Beef insulin will continue to be supplied by Rhone-Poulenc Rorer, which had also planned to leave the market but reversed the decision after renegotiating its price.

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