Insulin antibodies in diabetic children treated with monocomponent porcine insulin from the onset: relationship to B-cell function and partial remission.

Insulin antibodies expressed as insulin binding capacity of IgG were determined in 50 Type 1 (insulin-dependent) diabetic children who have been treated with monocomponent porcine insulin from the onset of the disease. During the follow-up period of 0.5-5.5 years (mean +/- SD: 3.2 +/- 1.6 years), 26 out of 50 patients (52%) developed detectable insulin antibodies. These patients had significantly lower maximal C-peptide responses to a standardized breakfast 9 months after onset of diabetes (mean 0.24 pmol/ml, p less than 0.001) than those without insulin antibodies (mean 0.47 pmol/ml). In addition, patients with antibodies showed both significantly higher insulin requirements at 9 months (p less than 0.05), and shorter remissions (p less than 0.01) than those without. It is concluded that even 'small' amounts of insulin antibodies may be biologically significant and have negative effects on B-cell function and metabolic balance.