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  • 1
    ISSN: 1432-0428
    Keywords: Insulin binding capacity ; insulin antibodies ; highly purified insulins ; isophane insulin
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Highly purified insulins offer the possibility of reducing insulin antibody levels and insulin requirement. Those likely to respond cannot be predicted on clinical grounds and a simple laboratory test is recommended for this purpose. This is based on insulin binding capacity (IBC) of plasma and has been used to follow a group of 47 patients over six months. 47 patients previously treated with British soluble and isophane insulins were changed to highly purified Leo Neutral and Leo Retard. 36 showed a reduction of insulin requirement and two groups could be identified. An IBC of 〉40 μU/ml was associated in 94% with a reduction of insulin dose; if the IBC was less the response was unpredictable. The initial IBC was related to the initial insulin requirement and to the eventual percentage reduction. Serial measurements in patients with high initial IBC showed a steady fall. Measurement of the IBC is a simple investigation; if the level is 〉40 μU/ml changing to a highly purified insulin is likely to be associated with reduction of insulin requirement.
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Springer
    Diabetologia 16 (1979), S. 5-12 
    ISSN: 1432-0428
    Keywords: Insulin deficient diabetes ; islet-cell antibodies ; free insulin concentration ; autoimmune diabetes mellitus ; Self-monitoring of blood glucose ; HbAl
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Comparisons are made between the incidence, prognosis and treatment of juvenile-onset diabetes and other endocrinopathies in the young. 548 patients with insulin deficient diabetes diagnosed before 20 years of age have been reviewed. Excess mortality, especially at 35–40 years of age was found. Profiles of blood glucose and serum insulin have been studied and compared to those of normal subjects. The variation of insulin absorption and effect of insulin antibodies on the free insulin levels achieved after exogenous insulin injection have been demonstrated. The common occurence of nocturnal subclinical hypoglycaemia following intermediate or long-acting insulin was often found to be the cause of poor diabetic control. Five out of 33 patients with ‘difficult’ diabetes had an unexplained resistance to high levels of free-insulin. The value of self-monitoring and HbAl measurements in the improvement of diabetic control and possibly life expectation is reviewed. The incidence of thyroid disease was found to be increased in 1779 insulin deficient diabetics of all ages and persistence of islet-cell antibodies suggests that the diabetes may be due to autoimmunity in some of these patients.
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1432-0428
    Keywords: Factitious diabetes ; insulin resistance ; insulin-binding antibodies
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary A case of factitious diabetes is reported. The patient gave herself insulin intermittently over a four year period. A high concentration of insulin binding antibody was found with the antibody showing much greater avidity towards beef than human insulin. There was resistance to intravenously administered beef insulin with low concentrations of free insulin and high concentrations of bound insulin. In contrast, in response to a glucose tolerance test, both the free insulin and C-peptide responses were normal as was glucose tolerance. The clinical difference in responsiveness to the human and beef insulins is well illustrated in vitro by insulin binding differences and is probably a function not only of different equilibrium constants of the antibody for human and beef insulins but also of different high affinity binding site concentrations.
    Type of Medium: Electronic Resource
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  • 4
    ISSN: 1432-0428
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Résumé Il a été démontré que l'albumine peut prévenir mieux que la gélatine la perte d'insuline d'une solution contenant de l'insuline. Ceci a probablement conduit à des rapports erronés de taux d'ILA élevés dans les dosages avec des méthodes biologiques. Des préparations d'albumine humaine cristalline ne montraient ni d'ILA, ni d'insuline décelable par la méthode radio-immunologique. L'albumine humaine préparée après extraction par l'alcool-acide (qui dans des expériences antérieures a démontré des propriétés anti-insuliniques avec l'hémidiaphragme isolé du rat) montre une ILA considérable avec le tissu adipeux isolé du rat et aussi de l'insuline qui peut être démontrée par la méthode radioimmunologique.
    Abstract: Zusammenfassung Es konnte gezeigt werden, daß Albumin stärker als Gelatine den Insulinverlust insulin-haltiger Lösungen verhindern kann. Das hat wahrscheinlich zu falsch erhöhten Spiegeln der insulinähnlichen Aktivität (ILA) geführt, über die bei Bestimmung mit biologischen Methoden berichtet wurde. Präparate kristallinen menschlichen Albumins zeigten keine ILA und auch kein mit der radioimmunologischen Methode bestimmbares Insulin. Menschliches durch Säurealkohol-extraktion gewonnenes Albumin (das nach früheren Untersuchungen insulinantagonistische Eigenschaften am isolierten Rattenhemidiaphragma hat) zeigte am isolierten Rattenfettgewebe eine deutliche ILA und auch mit der radioimmunologischen Methode bestimmbares Insulin.
    Notes: Summary Albumin has been found to be more effective than gelatine in preventing insulin loss from insulin containing solutions. It is probable that this has led to falsely elevated levels of insulin-like activity (ILA) reported with bio-assays. Preparations of crystalline human albumin have been found to be free from ILA and from insulin measured by the radio-immuno-assay. Other human albumin prepared by acid-ethanol extraction (that has been shown previously to contain insulin antagonistic properties on the isolated rat hemidiaphragm) has contained significant ILA on the isolated rat fat pad and also contained insulin demonstrable by radio-immuno-assay.
    Type of Medium: Electronic Resource
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  • 5
    ISSN: 1432-0428
    Keywords: Insulin ; proinsulin ; pancreatic polypeptide ; glucagon ; antibodies
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The sera of 30 patients who had been treated with conventional beef insulin were tested for binding of insulin and other pancreatic hormones. All showed antibody binding of insulin, 29 binding of proinsulin, 29 binding of pancreatic polypeptide, two binding of glucagon but none of the sera bound vasoactive intestinal peptide or somatostatin. After changing therapy to highly purified pork insulin the binding capacity of sera for insulin and the other hormones was monitored for up to 35 months and a steady fall was found in nearly all cases. In eight of the patients conventional beef insulin treatment was resumed: in one month binding of insulin and of the other hormones increased back to the initial levels. In eighteen subjects who had only received highly purified pork insulin low levels of insulin binding were found with no binding of proinsulin or other hormones. The amounts of proinsulin and contaminating hormones in highly purified pork insulin are so low that they are not immunogenic; conventional beef insulin not only contains immunogenic amounts of proinsulin and the contaminating hormones pancreatic polypeptide and glucagon but also is more immunogenic than purified pork insulin.
    Type of Medium: Electronic Resource
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  • 6
    Electronic Resource
    Electronic Resource
    Springer
    Diabetologia 19 (1980), S. 329-334 
    ISSN: 1432-0428
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
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  • 7
    Electronic Resource
    Electronic Resource
    Springer
    Diabetologia 16 (1979), S. 140-140 
    ISSN: 1432-0428
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
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  • 8
    ISSN: 1432-0428
    Keywords: Isophane insulin ; protamine zinc insulin ; insulin-antibody ; protamine ; protamine-antibody
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Sera from patients treated with different types of protamine-insulin were assayed for IgG antibody to protamine. A high prevalence of circulating antibody was found in patients treated with either bovine isophane insulin (26 out of 28 patients; 26 of whom also had antibodies to insulin), or bovine protamine zinc insulin (27 out of 30 patients; all 30 had antibodies to insulin). In sera from 24 patients treated with highly purified porcine isophane insulin, protamine antibody was detected in nine; circulating insulin-antibody was detected in 12 patients, eight of whom had protamine-antibody; in the 12 patients with no detectable antibody to insulin, antibody to protamine was detected in only one (χ2 = 8.7, P〈0.01). This relationship between insulin and protamine antigenicity is of interest as it suggests that the protamine-insulin complex is itself immunogenic.
    Type of Medium: Electronic Resource
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  • 9
    Electronic Resource
    Electronic Resource
    Springer
    Diabetologia 15 (1978), S. 19-22 
    ISSN: 1432-0428
    Keywords: Insulin-binding antibody ; bovine insulin ; porcine insulin ; association rate ; dissociation rate
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Insulin treated patients frequently develop insulin-binding antibody. Antisera from some patients, treated with bovine or bovine/porcine insulin mixtures, react differently with bovine and porcine insulin while for others there is no difference: when there is a difference there is greater avidity for bovine than porcine insulin. We studied antisera from 16 patients who had previously been treated with bovine insulin and then were changed to porcine insulin. Dissociation rate constants and association rates were measured with bovine and porcine insulin. Significant differences were found in association rates, which correlated well with binding at equilibrium (r=0.91), but not in dissociation rates. For 11 subjects who stayed on highly purified porcine insulin, long term reduction in insulin requirement correlated with the magnitude of the difference in antibody reaction to bovine and porcine insulin (r=0.74).
    Type of Medium: Electronic Resource
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  • 10
    ISSN: 1432-0428
    Keywords: Type 1 diabetes ; insulin ; insulin antibody ; pharmacokinetics
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Insulin withdrawal studies were performed in 12 Type 1 (insulin-dependent) C-peptide negative diabetic patients with low to moderate insulin antibody levels, to assess the biological availability of antibody-bound insulin and its clinical significance. There was a highly significant correlation between the extent to which the free insulin concentration was maintained during the period of insulin withdrawal and both the level of insulin-binding by serum and the total insulin concentration at the start of the study. During insulin withdrawal, the patients who best maintained their circulating free insulin levels showed the smallest increases in blood glucose and 3-hydroxybutyrate concentrations. We conclude that antibody-bound insulin is available for physiological action, and that in those individuals with moderate antibody concentrations it is capable, in the fasting state, of maintaining free insulin levels. In these circumstances insulin antibodies are behaving as simple carrier proteins.
    Type of Medium: Electronic Resource
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