George E, Bedford C, Peacey S R, Hardisty C A, Heller S R
Diabetes Centre, Northern General Hospital, Sheffield, UK.
Diabet Med. 1997 Jun;14(6):442-8. doi: 10.1002/(SICI)1096-9136(199706)14:6<442::AID-DID386>3.0.CO;2-W.
We tested the hypothesis that transfer from porcine to human insulin causes a fall in nocturnal blood glucose and an increase in the frequency of hypoglycaemic episodes. Twenty IDDM patients (age 19-55, duration 3-36 years) used Velosulin and Insulatard twice daily for 12 weeks, double-blinded to species (human (H) or porcine (P)) in a randomized crossover study. Species was changed after 4 weeks' run-in and 4 weeks later, with insulin doses unchanged on transfer. Ten patients underwent each sequence (H/P/H or P/H/P) and were admitted on the first and eighth night after transfer for hourly blood glucose measurement (22.00-07.00). Biochemical hypoglycaemia (<3.5 mmol l(-1)) was observed on 39 of the 80 patient-nights studied (48.75%). The number of episodes were similar during each night (H1 8, H8 10, P1 10, P8 11, p = 0.83). Total reported symptomatic episodes (H 51 vs P 73, p = 0.85), total HbA1 (H 9.8 +/- 0.3%, P 10.0 +/- 0.3%, p = 0.32) and daily insulin doses (H 0.63 +/- 0.04 units kg(-1) day(-1) vs P 0.63 +/- 0.05 units kg(-1) day(-1), p = 0.54) were not different. Despite an apparent fall in blood glucose levels from night 1 to 8 on transfer to human (AUC 82.3 +/- 7.8 vs 61.4 +/- 5.3 mmol.h l(-1), p < 0.05) but not porcine insulin (AUC 70.7 +/- 7.2 vs 70.1 +/- 7.5 mmol.h l(-1), p = 0.74), there was no difference when all 4 nights were considered together (p = 0.30). We conclude that dose for dose transfer to human insulin does not increase numbers of episodes of nocturnal or reported hypoglycaemia.
从猪胰岛素转换为人胰岛素会导致夜间血糖下降以及低血糖发作频率增加。在一项随机交叉研究中，20名胰岛素依赖型糖尿病患者（年龄19 - 55岁，病程3 - 36年）每日两次使用速秀霖（Velosulin）和诺和灵N（Insulatard），为期12周，对胰岛素种类（人胰岛素（H）或猪胰岛素（P））进行双盲。在4周导入期后更换胰岛素种类，4周后再次更换，转换时胰岛素剂量不变。10名患者接受每个序列（H/P/H或P/H/P），并在转换后的第一个和第八个晚上入院进行每小时一次的血糖测量（22:00 - 07:00）。在所研究的80个患者夜间中，有39个（48.75%）观察到生化性低血糖（<3.5 mmol l⁻¹）。每个晚上的发作次数相似（H1为8次，H8为10次，P1为10次，P8为11次，p = 0.83）。报告的总症状性发作次数（H为51次，P为73次，p = 0.85）、总糖化血红蛋白（H为9.8 ± 0.3%，P为10.0 ± 0.3%，p = 0.32）以及每日胰岛素剂量（H为0.63 ± 0.04单位·kg⁻¹·天⁻¹，P为0.63 ± 0.05单位·kg⁻¹·天⁻¹，p = 0.54）均无差异。尽管转换为人胰岛素后从第1晚到第8晚血糖水平明显下降（曲线下面积82.3 ± 7.8 vs 61.4 ± 5.3 mmol·h·l⁻¹，p < 0.05），但转换为猪胰岛素时并非如此（曲线下面积70.7 ± 7.2 vs 70.1 ± 7.5 mmol·h·l⁻¹，p = 0.74），然而当综合考虑所有4个晚上时并无差异（p = 0.30）。我们得出结论，等量转换为人胰岛素不会增加夜间或报告的低血糖发作次数。
