The efficacy of
sulfated beef insulin for plasma
glucose control in 35 patients with immunologic
insulin resistance was studied. Patients were on a mean dose of 550 U./day (range 200--2,000) of U-500 regular beef
insulin. Mean maximum 125I-insulin-binding capacity was 191 mU./ml. serum (range 13--1,080). Mean in vivo half-life (T 1/2) of 125I-regular beef
insulin was 614 minutes (range 114--1,300), as against a mean T 1/2 of 13.9 minutes (range 11.8--16.5) in normal controls. Treatment was successful in 34 patients and unsuccessful in one with
lipoatrophic diabetes. The mean initial dose of sulfated
insulin was 89 U./day (range 15--400) and at three months was 66 U./day (range 20--400). Twenty-eight patients who responded and survived have been on sulfated
insulin for a mean of 39 months (range 2-66) and are on a mean dose of 25 U./day (range 0--100). The mean maximum binding capacity fell to 9 mU./ml. (range 0--34) during
therapy (p less than 0.01). Mean 125I-insulin T 1/2 fell from 614 to 249 minutes after sulfated
insulin therapy (p less than 0.001). A comparative study of 15 patients on consecutive days showed a 35 sulfated
insulin T 1/2 of 60 minutes (range 15--94) and a mean 125I-regular
insulin T 1/2 of 246 minutes (range 62--560, p less than 0.001). These results indicate that sulfated
insulin is less antigenic than regular beef
insulin and combines less avidly with human
antibodies to regular beef
insulin. The response to sulfated
insulin therapy was significantly better than the response reported by other investigators to pork
insulin or to
steroid therapy in similar patients.