Human insulin, pork insulin and me

By | 26 April, 2011

My hypo warning signs disappeared with the advent of ‘human’ insulin. My change from pork to human was accompanied by a spanking new insulin pump, one of the first, and the fact that it caused extremely severe hypos here, there and everywhere was lauded as wonderful news by my diabetes nurse – I was so much better controlled now!

Pork insulin is real insulin obtained from the pancreases of pigs slaughtered for meat. Insulin is a protein made up of two amino acid chains, joined and ‘folded’ into a particular shape.

Pork insulin differs only slightly from human insulin, by one terminal on one of the amino acid chains.

‘Human’ insulin is made in vats by genetically modified bacteria or yeast cells. The two chains are made separately and chemically combined. But they will not function as insulin until they are ‘folded’ by a secret procedure. After folding, it is identical to real human insulin.

I have no idea why ‘human’ insulin does not agree with me, but can only conclude that the fault lies somewhere in its manufacture – unfolded chains perhaps?

My consultant had – through ignorance presumably – also kept me on long-acting Ultratard. Ultratard was a long-acting insulin injected for basal last thing at night. This prolonged my very severe hypos, and along with other issues, eventually forced me to give the pump up after a year of trying.

I was then moved to a new, shiny Novopen and a new blood-testing machine. By then I was used to the hypos and didn’t connect them with my move to human insulin.

My problems were not a worry to anyone other than me until I wanted children. At which point, after a hypo that saw me into hospital, they kept me in to try and ‘balance’ me. My consultant at the time couldn’t manage it and while he was at a conference another consultant ‘stole’ me and tried himself.

It took six weeks and no exercise but at last I stopped swinging quite so violently and was allowed home with folic acid to try for a family. Once pregnant (this was an IVF baby) I stayed on the sofa for nine months. I had another baby 5 years later and managed by being very careful, but also, my control became a lot easier whilst pregnant.

Then I was changed to another human insulin – Humalog – and experienced other symptoms. Two of my fingers suddenly wouldn’t bend – then wouldn’t straighten. I could no longer do the lotus position or get my leg behind my head (not a pressing problem, I admit) because one of my ligaments wouldn’t stretch. My hypos became much more severe and frequent.

So I was started on an insulin pump – a Minimed 507 with Humalog. I think the continuous supply exacerbated things – my fingers almost seized up. The pain was much worse. I was getting pains in muscles. I was suffering memory loss and felt tired. In the end I looked up these symptoms and found the Insulin Dependent Diabetes Trust– and changed to using pork insulin in the pump.*

What a difference! Within DAYS I was thinking more clearly, my body (and this is the only way I can describe it) felt ‘calmer’. I slept better. My hypos decreased (from 10 a day to about three) and weren’t as severe, I wasn’t irritable all the time, the pains disappeared and in three weeks my fingers freed up and I could move them. They are still fine.

I now have an utterly wonderful team at hospital, and excellent care I can’t fault. A pump, with tiny doses, and pork insulin, a team who listen, the possibility of CGM on the horizon and my little trained alert dog, Lola, all of which now keep me as controlled as I am ever likely to be! A far cry from being thrown out of a ward because my blood sugars were uncontrollable as a teenager – I was trying, honest, I was not eating sweets! Or being told by a consultant that my tiny doses were ‘homeopathic’ and I should eat more! I often wonder if anyone else had similar problems with getting health care officials to believe them. Have you?

*Advice on symptoms possibly related to human insulin is available from http://www.iddt.org/

14 thoughts on “Human insulin, pork insulin and me

  1. Alison

    Wow @Lizz what a journey. I was lucky in that I went straight onto human insulin at diagnosis and had no problems, but I’ve met so many people who have problems with the human stuff. ITTD do a great campaigning job on the subject, but I’ve always had the impression that this is an issue that a lot of people just like to sweep under the carpet and pretend it doens’t exist. Thanks for your post.

  2. Nig

    @Lizz – its good to “meet” another porcine user!

    I was on “Human” insulin for about four or five years in the late eighties and completely lost my hypo warning symptoms and had difficulty controlling my BG – leading of course to more unpredictable hypos with no warnings! Thankfully I had no other effects as you and others have had affecting muscles, tendons and other tissues and obviously pregnancy wasn’t an issue for me personally! However, if my girlfriend/fiancee/wife hadn’t been so supportive during that period we wouldn’t have survived as a couple and our daughter wouldn’t have been possible!

    During the time I was on human insulin I had no problems with health care professionals since none of them knew I was taking human insulin!! Perhaps I should explain!

    Having wasted much of my life since the age of ten sitting in hospital waiting rooms, I decided when I left home that hospitals were a waste of time and just registered with GPs to get my prescriptions. I just got called in once a year for a chat with the GP. They would invariably say “well you’ve been diabetic for X years, you’ve got no complications, you obviously know what you are doing, just carry on”.
    Then one day in about 1985 I popped into Boots during my lunch break to get my insulin prescription and was told by a very junior shop assistant (not a pharmacist) that the insulin on my prescription was going to be withdrawn and would I like them to issue me with the new “human” insulin that would be replacing it? I remember thinking that it was a strange way to run a health service but that if they were making the switch on such an informal basis then there must be no major difference between the two insulins (!) so, what the heck, go ahead. They even told me I should go back to my doctor and get him to change the prescription to read “human Insulin” to avoid confusion in the future since it just showed the name of the insulin (which I can’t now remember) and didn’t distinguish between human or pork. Thankfully, I never did get him to change the prescription. Each time I took my prescription to a chemists (often, but not exlusively Boots) I was asked “is this for human or pork insulin” to which I replied “human”. Over the next few years, my hypo awareness disappeared completely and my control became random at best. My girlfriend was tremendously supprtive in trying to help keep my blood sugar within limits (bearing in mind that at that time I was still relying on the old visual blood test strips not using a meter) It was then (in the late 1980’s) that I started to read about people experiencing problems with human insulin. As I read more I wondered if that could be the cause of my hypo-unawareness and random blood sugar readings. So next time I went to the chemists to get my insulin and they asked “is this human or pork insulin” I answered “pork” and switched myself back. Within a week, my hypo symptoms had returned (and after a total of 40 years, I still have them) and my control was back to how it had been before changing to human insulin.
    This is where I started to encounter disbelief from healthcare professionals. Apart from my current GP who has never had an issue with me staying on pork insulin, almost every other health care professional I have had dealings with (apart from surgeons, who quite reasonably don’t care what type of insulin you are using!) has at best looked askance at me and at worst has accused me of making up the problems and not wanting to take care of myself by not switching to the latest best thing!
    I did try Lantus at the suggestion of my GP to try and improve the basal coverage I was getting from porcine Isophane insulin but had the worst hypo of my life with no warning so dropped it after about a fortnight.
    As a result of other health issues my GP has now referred me to my local hopsital diabetic clinic who have suggested I need a pump. They are completely unfamiliar with pork insulin and have suggested that once they have had a chance to get their heads around my other complicating factors they would want me to switch to an analogue insulin. In conversations with the DSN who deals with the pumps it seems she has been told to proceed on the basis of my using porcine insulin in the pump and although she has reservations will do some research on using animal insulins in pumps. I have given her a copy of http://www.input.me.uk/wp-content/uploads/2011/03/JDN15-1pg32-6.pdf but if anyone has any other research or journal articles relating to the use of animal insulin in pumps I’d be pleased to hear about them.
    Anyway, I am pleased you have got some sense of balance back on the porcine insulin, Lizz 🙂 We should just be thankful that it is still available in this country 🙂 having been withdrawn in many parts of the world and replaced with “better” insulins 🙁

    1. lizz Post author

      Nigel, I had quite a few pump blockages whilst on Humalog – Having done a lot of research I found that things called insulin ‘fibrils’ accumulate in the cannula and cause them. Nothing like this happens with pork – in all the years I’ve been using it I’ve had no blockages whatsoever, and no other problems with using pork in the pump. I use Wockhardt Hypurin porcine insulin, which has a fairly quick action, but I need to bolus half an hour ahead of meals. This does take away somewhat from the freedom of using a pump, but is worth the hassles for reasons you know only too well! I also set the period of action of the insulin to 6 hours, this may be different for you, but just as a guide.

  3. Nig

    Thanks Lizz. The article I linked to above refers to three articles which specifically address the use of animal insulins in pumps and states “Of these, only one indicated any potential problems with the use of animal insulin in pumps, namely a hypothetical tendency to block the cannula (Eichner et al, 1988), based solely on a theoretical consideration of the different solubilities of the insulin molecules.” It seems your practical experience supports the view that it is just a hypothetical risk 🙂
    Yes, hooray for Hypurin 🙂 ! Since I try :o: to inject 30 mins before meals I can’t see telling a pump to do the same as a great problem.
    Thanks for the note on period of action. Based on the action of *injected* Hypurin porcine I would have guessed that 6 hours would be the appropriate period of action for me to use with a pump as well (but I appreciate that I am getting a bit ahead of myself since I haven’t got a pump yet!).
    I have just finished a phone call with my Omnipod rep who is going to consult with his colleagues to find out what history they have with using animal insulins in that pump.

  4. Hairy Gnome

    @lizz – My first reaction was the same as @Alison‘s – Wow! My second reaction was; ‘I’m really glad I don’t have that problem, I don’t think I could get my head around it!’ My third reaction was; ‘Insulin from dead pigs? Eeeww,’ but I’m sure you would have mentioned it if you’d started to grunt, so it must be good. Joking aside, coping with diabeasties is bad enough, but all the additional problems make it horrendous.

    All I can say is well done, and the best of luck, you deserve a very big hug! 😛

  5. Scott S

    This is a subject that is close to me personally, only the U.S. Fatal, I mean Food and Drug Administration (“FDA”), has basically outlawed animal-sourced insulin in the U.S. (in spite of the fact that most synthetic, recombinant insulin analogues are no closer to human insulin than is porcine insulin … is there a political agenda? I believe in the U.S. there has been, as 2 of the biggest donors to the U.S. republican political party were Eli Lilly & Co. and Novo Nordisk, and until recently, the goal of the FDA was to approve drugs as quickly as possible with no after-market studies required). Having said this, you might find my book review on “Invisible Frontiers: Race to Synthesize a Human Gene” interesting reading, see http://goo.gl/Iwxz2 for that review). With the Obama administration in office and new leadership at the FDA, there has been a relaxation of importation rules from the 2 regulatory bodies that had a say in the matter, enabling importation from the UK (where it is available, but extremely costly), or from Argentina whose domestic supplier Laboratorios Beta S.A. also makes animal-sourced insulin), where it remains available and is more popular for export than it is among the native population).

    Incidentally, Merck Organon N.V. based in the Netherlands still makes it for Lilly’s animal pharmaceutical unit, which is mainly a contract manufacturer, still sells animal-sourced insulin in the U.S. for dogs and cats. Anyway, thanks for sharing your experience!

    1. pam maske

      I’m against the Protect IP Act as written. If it passes, then it will be more difficult for diabetics to import the natural pork & beef insulin that they need for survival and quality of life. Eli Lilly stated that rDNA synthetic human insulin wouldn’t work for some diabetics and rDNA human insulin is the only insulin available in America. Why isn’t natural pork & beef insulin protected by the “Orphan Drug Act”? Pork & Beef insulin should be available in America again for diabetics. My son imports his pork insulin from Canada and his doctor said that he’s beating all the odds. He’s had diabetes for 37 years, since he was 3 years old and he has 20-20 vision. Scott, thank you for recommending the movie ” Puncture “. You & I both know that the same thing is happening with natural pork and beef insulin here in America. Like you, I will continue to fight to get the natural pork and beef insulin back in America again for diabetics who need it and my son is one. Only people who don’t have diabetes or people who have never been on the natural pork and beef insulin, think that the rDNA synthetic human ( not human ) insulin is a safer insulin. NOT! Thank you on behalf of all diabetics and that includes my son.

  6. lizz Post author

    Of course Humalog is an analogue insulin, and analogues are unlike any insulin of any mammal on Earth, but are very close in structure to human insulin-like growth hormone, a carcinogen, and one of the reasons that some Drs are worried about their use.

  7. Cecile

    I thought it was Lantus that was accused of binding to insulin-like growth factor receptors (IGFs themselves are necessary parts of your physiological parcel)

    I’d rather not use mashed up mammal bits – if we all did, our meat consumption (and methane production) is going to have to treble, and heat up our global oven even more…and strictly speaking, we’re all colonies of single cells, no need to get snotty about bacteria just ’cause they’re prokaryotes 🙂

  8. lizz Post author

    Lol! Banting and Best ‘gave’ the world insulin and how to use it – it doesn’t get any pharmaceutical company big bucks for its use. I have read somewhere that the arguments that there isn’t enough meat production is not true, but nowadays things are getting a little more pressing…

  9. Nig

    @ckoei – not snotty about e-coli – it just doesn’t work for me! Similarly, no-one needs to use “mashed up mammal bits” if its not right for them. My beef (pun intended) is that the big 3 insulin producers have unilaterally (can 3 firms act unilaterally?) withdrawn animal insulins with no regard for the impact on the 10 – 20% of insulin dependent diabetics who are better-off on animal insulins. I just want people to have choice – choice of what’s best for them.

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