Journal of Clinical Endocrinology & Metabolism, Vol 52, 948-952, Copyright © 1981 by Endocrine Society

ARTICLES

Antibodies to insulin, pancreatic polypeptide, glucagon, and somatostatin in insulin-treated diabetics

D Fitz-Patrick and YC Patel

The hormonal content of the commercial insulins most commonly used in Canada (Connaught) and the USA (Lilly) was measured, and the prevalence of antibodies to these hormones was determined in the serum of diabetics treated with one of these preparations. Connaught insulins contained 62 +/- 10 ng pancreatic polypeptide (PP)/100 U insulin, 11 +/- 2 ng glucagon/100 U, and 56 +/- 16 pg somatostatin (SRIF)/100 U. Lilly single peak insulins contained 693 +/- 41 pg PP/100 U, 8 +/- 2 ng glucagon/100 U, and 323 +/- 174 pg SRIF/100 U, whereas the recently introduced Lilly improved single peak insulins contained 8 +/- 2 ng PP/100 U, 30 +/- 10 ng glucagon/100 U, and 43 +/- 1 pg SRIF/100 U. Lilly highly purified Iletin II pork insulin contained 1.0 ng PP/100 U, 0.4 ng glucagon/100 U, and 19 pg SRIF/100 U. Of 111 diabetics treated with Connaught insulin, 91% had antibodies to insulin, 51% had antibodies to PP, 14% had antibodies to glucagon, and 6% had antibodies to SRIF. Antibodies to PP were also found in 2 control subjects (n = 30). In patients who had taken Connaught insulin for 10 yr or more, 97% had insulin antibodies, 84% had PP antibodies, 14% had glucagon antibodies, and 11% had SRIF antibodies. Fasting serum GH levels were normal in all patients with SRIF antibodies. Cord blood from two pregnancies in insulin-treated diabetic mothers contained antibodies to the same hormones as maternal production of antibodies to insulin, PP, glucagon, and SRIF. The importance of these antibodies in the pathophysiology of diabetes is discussed.