Monocomponent insulin

Insulin allergy occurs in as many as 3% of patients receiving pork or beef insulin but smaller proportion in those using human insulin. However, the immuno-genicity of insulin is determined more by the purity of its preparations and since the use of monocomponent insulin, insulin allergy has become extremely rare. 

Allergic reactions to insulin were originally thought to be caused by impurities present in the formulation. However, after the introduction of monocomponent insulins and human synthetic insulins, these reactions continued to be seen, even in patients without a history of treatment with other insulins (142). Switching from animal to human insulin can paradoxically cause allergic reactions, which subside when treatment with animal insulin is re-introduced... 

Mitoxantrone hydrochloride Mitrazapine Mometasone furoate Monocomponent insulin Monohydrate sodium, hyaluronate soln... 

The appearance of purified (repeatedly recrystallized) insulins and more recently of monocomponent insulins has brought about a diminution in the rates of local reactions, formerly observed at the site of injection in 40%-56% of cases (Paley and Tunbridge 1952), and generalized reactions such as urticaria or anaphylactic shock (Feinglos and Jegasothy 1979 Jorpes 1949 Kreines 1952 Ljung 1952 Mirouze et al. 1973 Sherman 1954 Wolfromm and Nataf 1965 Liebermann et al. 1971 DE Shazo 1978). 

A generalized reaction, manifested by a generalized urticaria or Quincke s edema, or sometimes taking the form of anaphylactic shock with digestive and respiratory symptoms (Aubert et al. 1968 Capbell et al. 1930 Hanaver and Baston 1961 Rose and Barron 1955). Although these manifestations are rare (estimated at 1 or 2 per 1,000 in 1965) they are still observed, even with monocomponent insulins. 

This intrinsic insulin antigenicity seems to be confirmed by the fact that the use of monocomponent insulin can be followed by a local reaction with eosinophilic... 

Extracted porcine C-peptide (21), porcine glucagon (24), porcine monocomponent insulin (25), porcine pancreatic polypeptide (36), porcine proinsulin (30), somatostatin (24), vasoactive intestinal polypeptide (19)... 

On the basis of data on metabolism of human monocomponent insulin in 6 women on oral contraceptives and 10 controls it has been suggested that capillary permeability to insulin is increased as well as the peripheral degration in women on oral contraceptives (119 ). The results indicate a significant alteration in insulin metabolism which may contribute to the impairment of carbohydrate tolerance seen in some women taking combined oral contraceptives. 

Jones GR, Statham B, Owens DR, Jones MK, Hayes TM. Lipoatrophy and monocomponent porcine insulin. BMJ (Clin Res Ed) 1981 282(6259) 190. 

---