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August 26, 1983

Future of Human Insulin

Author Affiliations

Henry Ford Hospital Detroit

JAMA. 1983;250(8):1027-1028. doi:10.1001/jama.1983.03340080017016

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To the Editor.—  Human insulin derived from recombinant DNA represents a striking advance in medical technology. Future uses of recombinant DNA technology likely will overshadow human insulin, for only a minority of humans benefit from the latter's availability, while future gains from this technology should benefit everyone.While Miller's discussion (1982; 248:1503) is accurate and appropriate, I seem to detect negative connotations. Most questions about human insulin now are unanswered. Clinical experience encompasses only two years; greater breadth and depth of experience will accumulate over the years. No one yet knows whether long-term therapy with human insulin will substantially benefit the diabetic patient when compared with the use of highly purified animal insulins. However, the possibility does exist that purified homologous insulin, even delivered subcutaneously, will be safer and less immunogenic than any animal insulin. Early reports from clinical studies support the possibility that circulating antibody titers decline when patients