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| Which
insulin to use? Human or animal? by V.Mohan., Current Science.,
Vol 83, No.12, 25 Dec. 2002 |
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| Animal
Insulin : Revisited by Dr. Anil S. Bhoraskar, API Medicine
update, Vol 12, Chapter 44, 2002 |
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| Cochrane
review -Endocrinology and metabolism clinics of North America
- Sep 2002 |
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| Youth-onset
Diabetes in India by N. Kochupillai and R. Goswami, RSSDI
Textbook of Diabetes, April 2002. |
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|
Insulin Antibody Response to Bovine Insulin Therapy by N.
Kochupillai , API Medicine update, 2002. |
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| Insulin Antibody Response to Bovine Insulin
Therapy: Functional Significance Among Insulin Requiring
Young Diabetics in India |
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| Padmashri.Prof.Dr.N.Kochupillai.MD,
FAMS, FNA, FASc. |
| Department
of Endocrinology & Metabolism, All India Institute
of Medical Services, New Delhi. |
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| API Medicine update, 2002. |
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The majority of young diabetics in India prefer to use
low-cost bovine insulin for economic reasons. Therefore,
the question of insulin antibody response to bovine insulin
and its functional significance is still relevant in the
Indian context. We assessed insulin antibody response in
52 young diabetics (type 1, n=25, malnutrition modulated
form of diabetes, n = 19 and fibrocalculous pancreatopathy
(FCP) n = 8) on bovine insulin therapy (mean duration 3.0
± 2.1 years) using an internationally standardised
in-house radioligand assay. The functional significance
of insulin antibody was assessed by calculating their affinity
constant, maximum binding capacity and total insulin binding
power by Scatchard analysis (type 1, n = 14,malnutrition
modulated form of diabetes, n = 11 ). All the patients treated
with bovine insulin showed high liters of insulin antibodies
with S.D. score ranging from 5.1 to 42.0. No significant
difference was observed in the mean S.D. score of insulin
antibodies in the three diabetic groups. The mean daily
insulin dose, maximum insulin binding capacity and total
insulin binding power were significantly higher in type
I when compared to the malnutrition modulated form of diabetes
(36 ± 8 vs. 26 ± 11 | U/day, P< 0.005;
9.7 ± 7.8 vs. 4.0 ± 3.9 nmo1 / 1, P = 0.03
and 59 ± 29 vs 29 ± 43, P = 0.01, respectively).
Insulin antibodies S.D. score and its affinity did not show
significant relationship with daily insulin dose and glycemic
control (HbA1) at admission. Only 24 ± 7 % variations
in daily insulin requirements were accounted for by total
insulin binding binding power. There was a significant inverse
relationship between insulin antibody S.D. score and duration
of insulin therapy (r=-0.04 172, P<O .OOOA). To conclude,
insulin antibody response following bovine insulin therapy
is not different among type 1, malnutrition modulated form
of diabetes and FCP diabetes. The insulin antibody response
to bovine insulin therapy is not different among type 1,
malnutrition modulated form of diabetes and FCP diabetes.
The insulin antibody respondent bovine insulin therapy does
not contribute significantly to increase in daily insulin
requirement in bovine insulin treated insulin requiring
young diabetics.
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