The Insulin Dependent Diabetes Trust [IDDT] formed in the UK
in 1994 to help and support people with diabetes who need insulin
treatment, especially those experiencing problems with synthetic
insulins. The health and welfare of people with diabetes depends
on their active participation in their care and to achieve this,
the patient must have information about benefits, risks and alternatives
concerning treatment and must have appropriate facilities available
to make an informed choice of treatment.
The introduction of synthetic ‘human’ insulin
in 1982 resulted in many patients and their families reporting
adverse
effects that they had not experienced when using natural animal
insulins. However, these adverse reaction reports from patients
were largely ignored by their doctors, by diabetes associations,
by regulatory bodies and by the insulin manufacturers themselves
despite the fact that when these patients returned to their usuak
pork or bovine insulin the adverse effects largely disappeared.
‘Human’ insulin was introduced
with promises that it would be better for people because it
more nearly matched
natural endogenous insulin, it would not produce antibodies and
above all it would be cheaper and therefore more accessible people
throughout the world. None of this has in fact turned out to
be true:
- At best research has shown that there
are no clinical benefits for patients from using ‘human'
insulin as opposed to natural animal insulin.
- ‘Human’ insulin is more
aggressive, being faster acting and working for a shorter
duration than natural
animal insulins. Therefore there is an increased need for
more daily injections, a greater risk of hypoglycaemia and
of more
erratic blood glucose levels.
- Research has shown that ‘human’ insulin
does produce antibodies.
- After nearly 20 years, human insulin
is still significantly more expensive that animal insulins
and in poorer countries
where animal insulins have been withdrawn in favour of the
more expensive ‘human’ insulin,
people are now dying not for lack of insulin but for lack
of affordable insulin.
Clearly patients and many physicians were
misled when ‘human’ insulin
was introduced and this was made worse by the denial of the adverse
reactions reported by patients and their families by all their
advisers. This denial was based on the lack of ‘scientific
evidence’ to support their reports but no large-scale trials
ever took place to compare animal and ‘human’ insulin
and nor was any formal post-marketing surveillance carried out
despite the large number of patient adverse reports. The British
Diabetic Association [now Diabetes UK] alone received nearly
3000 reports but they took little action.
Since this time the major insulin manufacturers
have systematically discontinued natural animal insulins from
many countries but
they are still available in the UK, the US, Canada and some other
countries. In October 2002, Novo Nordisk reversed their policy
and agreed to continue to supply pork insulin in the UK. It is
important that people with diabetes have the insulin that suits
them best and that they are used to and they should not be forced
to use genetically produced ‘human’ insulin that
causes some people to suffer adverse reactions that affect their
health, wellbeing and quality of life. So it was with this background
and the need to ensure a continued supply of animal insulin that
IDDT was formed and to ensure that in future, people with diabetes
would receive full information about risks and benefits of any
new treatment based on reliable independent evidence from research.
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