Abstract
Sir—In her Aug 15 commentary Stephanie Amiel states that “hypoglycaemia is almost unavoidable with existing insulins”. She attributes the problem to pharmacokinetics, insulin being absorbed from its molecular moiety, instead of, as in nondiabetic people, being secreted by pancreatic islet cells, depending on blood sugar concentration. The study cited, which compares human and porcine insulins, omits a possibly important difference between animal pancreas-derived insulin and the newer (20 years or so) semisynthetic insulin. Cattle, porcine, and cadaver insulin, produced by an acid-alcohol extraction of whole pancreas, contains insulin from -cells and glucagon from -cells. The German physiologist Buerger in the last century called glucagon the counterregulatory hormone. It is little wonder that the newer insulin produces a sizeable number of hypoglycaemic Ventrolateral medullary decompression in essential hypertension
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