Fankhauser S, von Rohr E
Medizinische Klinik, Kantonsspital Olten.
Ther Umsch. 1990 Jan;47(1):41-8.
In Switzerland it is still a debatable point whether diabetics whose treatment has been changed from animal to human insulin notice premonitory symptoms of hypoglycemia to a lesser degree and whether this could be hazardous for them. In a prospective study, 18 longstanding type 1 and type 2 diabetics, treated with insulin Lente MC, were selected and observed at frequent intervals for three months. This first period was followed by a transfer to human insulin (Protaphan HM) and a close observation for another three months. Before the transfer, all patients were well informed about a possible change in premonitory symptoms of hypoglycemia. The initial dose of Protaphan HM was 10% lower than in the treatment with Lente MC. During the three month period with human insulin, we observed no change with regard to blood-sugar regulation or Hb-A1. The most important observation was that the number of hypoglycemic episodes did not change after the transfer to human insulin. There were only mild to moderate degrees of hypoglycemia, the average being three episodes per patient. The change to human insulin was without any problems for the patients: they all preferred to stay on Protaphan HM for future treatment. Also, in general practice, patients can be changed without difficulties from animal to human insulin, provided that the above-mentioned precautions are respected.
在瑞士，糖尿病患者从使用动物胰岛素改为使用人胰岛素后，是否会在较小程度上察觉到低血糖的先兆症状，以及这对他们是否有危害，仍是一个有争议的问题。在一项前瞻性研究中，选取了18名长期使用低精蛋白锌胰岛素（Lente MC）治疗的1型和2型糖尿病患者，并对他们进行为期三个月的频繁观察。在这第一个阶段之后，转为使用人胰岛素（优泌林HM）并密切观察另外三个月。在转换之前，所有患者都被告知低血糖先兆症状可能会发生变化。优泌林HM的初始剂量比使用低精蛋白锌胰岛素治疗时低10%。在使用人胰岛素的三个月期间，我们观察到血糖调节或糖化血红蛋白（Hb-A1）方面没有变化。最重要的观察结果是，转换为人胰岛素后低血糖发作的次数没有改变。低血糖发作程度仅为轻度至中度，平均每位患者发作三次。转换为人胰岛素对患者没有任何问题：他们都更愿意在未来的治疗中继续使用优泌林HM。此外，在一般临床实践中，只要遵循上述预防措施，患者从动物胰岛素转换为人胰岛素不会有困难。
