Insulin pork

Summary

Porcine (pork) insulin is a short-acting insulin derived and purified from the pancreas of pigs. Its amino acid sequence differs from human insulin by a single amino acid at position B30 (alanine instead of threonine). It was widely used for decades to manage type 1 and type 2 diabetes mellitus before the advent of recombinant human insulin and insulin analogues. It remains available in some countries as a lower-cost option.

Mechanism of Action

Binds to insulin receptors on cell membranes, activating receptor tyrosine kinase signaling; facilitates glucose uptake into muscle and adipose tissue, suppresses hepatic glucose output, promotes glycogen synthesis, inhibits lipolysis, and lowers blood glucose levels.

Routes of Administration

Goals & Uses

• Hyperkalemia managementElectrolyte ManagementModerate
• Diabetic ketoacidosis (DKA) managementAcute Metabolic EmergencyModerate
• Glycemic control in type 1 diabetes mellitusEndocrine / MetabolicHigh
• Glycemic control in type 2 diabetes mellitusEndocrine / MetabolicHigh

Contraindications

• Religious or cultural restriction to porcine productsCultural/ethicalModerate
• Known hypersensitivity to porcine insulin or excipientsImmunologicHigh
• HypoglycemiaMetabolicHigh

Adverse Effects

• HypokalemiaElectrolyteUncommon
• HypoglycemiaMetabolicCommonAbnormally low blood glucose
• Injection site reactions (lipodystrophy, lipoatrophy, lipohypertrophy)Dermatologic/localCommon
• Weight gainMetabolicCommonIncrease in body weight
• Allergic reactions (local or systemic)ImmunologicUncommon
• Insulin antibody formationImmunologicCommon

Drug Interactions

• Oral antidiabetic agents (sulfonylureas)Moderate
• Beta-blockersModerate
• AlcoholModerate
• CorticosteroidsModerate
• MAO inhibitorsModerate
• Thiazide diureticsLow

Population Constraints

• PregnancyReproductive SafetyRelative
• Hepatic impairmentOrgan FunctionRelative
• Renal impairmentOrgan ImpairmentRelative
• Pediatric patientsAgeRelative
• Elderly patientsAgeRelative

Regulatory Status

• European UnionApprovedApproved: Diabetes mellitus type 1, Diabetes mellitus type 2Hypurin Porcine products (Wockhardt) remain approved and available in the UK and some EU countries.
• United StatesWithdrawnApproved: Diabetes mellitusPork insulin (Iletin II, Eli Lilly) was previously FDA-approved but has been discontinued from the US market; recombinant human insulin and analogues dominate.
• United KingdomApprovedApproved: Diabetes mellitus type 1, Diabetes mellitus type 2Hypurin Porcine Neutral and Isophane available; licensed by MHRA. Used especially in patients with recombinant human insulin hypersensitivity or preference.

Pork insulin has been largely supplanted by recombinant human insulin and analogues in most Western markets. It remains approved and marketed in some countries. In the US, pork insulin (Iletin II) was historically available but has been largely discontinued. It is still obtainable in some regions including parts of Europe, Asia, and Latin America.

Evidence & Sources

No sources recorded yet.