Effect of human insulin and insulin analogue on some inflammatory markers and total antioxidant capacity in a sample of Iraqi type 1 diabetic children and adolescents


  • Noor Wafaa Hashim Department of clinical pharmacy/pharmacy college/Mustansiriyah University, Baghdad, Iraq
  • Kadhim Ali Kadhim Al-Yarmok University College / Pharmacy Department – Iraq – Baghdad
  • Abbas Mahdi Rahmah National Center for Diabetes Treatment and Research/ Mustansiriyah University,Baghdad,Iraq.




: human insulin, insulin analogue, hs-CRP, IL-6, TAOC


Background: Both human insulin and insulin analogue used in the treatment of type 1 diabetes mellitus. The modification in amino acids sequences of human insulin lead to produce analogue form which have a pharmacokinetic and pharmacodynamics effect near to normal human endogenous


insulin release.

Aim of study: This study designed to compare between the effect of each type of insulin on high sensitive C-reactive protein and interleukin-6 and total antioxidant capacity in a sample of Iraqi type 1 diabetic children and adolescents.

Study design: The study was enrolled on fifty-one Iraqi type 1 diabetic children and adolecence age range (6-18) year. The patients allocated into two groups, Group (1) includes 20 patients assigned to receive conventional human insulin (regular and NPH), and Group (2) includes 20 patients assigned to receive insulin analogue (insulin aspart and glargine) for three months. The inflammatory and antioxidant markers measured at baseline and after three months of intervention.

Results: After three months of treatment, both insulin groups did not affect high sensetive C_reactive protein (hs-CRP) significantly from baseline to 3 months. Only insulin analogue reduced Interleukin-6 (IL-6) significantly, while human insulin reduced   level of IL-6 but it was not statistically significant. Both therapies reduced total antioxidant capacity (TAOC) significantly; however, insulin analogue had higher reduction percentage (15.1% vs. 5.7%) compared to the conventional insulin.

Conclusion: Only insulin analogue reduced IL-6 significantly. Both types of insulins did not effect on hs-CRP. Both therapies reduce TAOC significantly.


- Brange J, Ribel U, Hansen J, Dodson G, Hansen M, Havelund S, et al. Monomeric insulins obtained by protein engineering and their medical implications. Nature. 1988;333(6174):679. DOI: https://doi.org/10.1038/333679a0

- Mathieu C, Gillard P, Benhalima K, Insulin analogues in type 1 diabetes mellitus: getting better all the time. Nature Reviews Endocrinology. 2017 Apr 21; 13:385. DOI: https://doi.org/10.1038/nrendo.2017.39

- High sensetive CRP ELISA for research https://www.calbiotech.com [Internet] available from https://www.calbiotech.com/elisa-kits-for-research/c-reactive-protein-elisa-detail.

- Pfutzner A, Forst T. High-sensitivity C-reactive protein as cardiovascular risk marker in patients with diabetes mellitus. Diabetes technology & therapeutics. 2006;8(1):28-36. DOI: https://doi.org/10.1089/dia.2006.8.28

- Tanaka T, Narazaki M, Kishimoto T. IL-6 in Inflammation, Immunity, and Disease. Cold Spring Harbor Perspectives in Biology. 2014;6(10): a016295. DOI: https://doi.org/10.1101/cshperspect.a016295

- Gomes KB. IL-6 and type 1 diabetes mellitus: T cell responses and increase in IL-6 receptor surface expression. Annals of Translational Medicine. 2017; 5(1):16. DOI: https://doi.org/10.21037/atm.2016.12.74

- Ozougwu JC, Obimba, K C, Belonwu, C D, Unakalamba, C B.The pathogenesis and pathophysiology of type 1 and type 2 diabetes mellitus. Journal of Physiology and Pathophysiology. 2013; vol 4(4) (Sep; 4(4): 48-50.). DOI: https://doi.org/10.5897/JPAP2013.0001

- Hundhausen C, Roth A, Whalen E, Chen J, Schneider A, Long SA, et al. Enhanced T cell responses to IL-6 in type 1 diabetes are associated with early clinical disease and increased IL-6 receptor expression. Science translational medicine. 2016; 8(356):356ra119. DOI: https://doi.org/10.1126/scitranslmed.aad9943

- Giugliano D, Ceriello A, Paolisso G. Oxidative stress and diabetic vascular complications. Diabetes Care. 1996; 19(3):257-67. DOI: https://doi.org/10.2337/diacare.19.3.257

- Gough SCL. A review of human and analogue insulin trials. Diabetes Res Clin Pract. 2007 Jul; 77(1):1–15. DOI: https://doi.org/10.1016/j.diabres.2006.10.015

- West IC. Radicals and oxidative stress in diabetes. Diabetic medicine: a journal of the British Diabetic Association. 2000; 17(3):171-80. DOI: https://doi.org/10.1046/j.1464-5491.2000.00259.x

- Halliwell B. Free radicals, antioxidants, and human disease: curiosity, cause, or consequence? Lancet (London, England). 1994;344(8924):721-4. DOI: https://doi.org/10.1016/S0140-6736(94)92211-X

- Andras Treszl, Laszlo Szereday, Alessandro Doria, et.al. Diabetes Care Nov 2004, 27 (11) 27692770; DOI: 10.2337/diacare.27.11.2769http://care.diabetesjournals.org/content/27/11/2769. DOI: https://doi.org/10.2337/diacare.27.11.2769

- De Vries, L., Bar-Niv, M., Lebenthal, Y. et al. Recovery of premorbid BMI trajectory without overshoot during the first year of treatment of children with type 1 diabetes. Acta Diabetol (2014) 51: 395.

- Alnek K, Kisand K, Heilman K, Peet A, Varik K, Uibo R. Increased Blood Levels of Growth Factors, Proinflammatory Cytokines, and Th17 Cytokines in Patients with Newly Diagnosed Type 1 Diabetes. PloS one. 2015;10(12): e0142976. DOI: https://doi.org/10.1371/journal.pone.0142976

- Heier M, Margeirsdottir HD, Brunborg C, Hanssen KF, Dahl-Jorgensen K, Seljeflot I. Inflammation in childhood type 1 diabetes; influence of glycemic control. Atherosclerosis. 2015;238(1):33-7. DOI: https://doi.org/10.1016/j.atherosclerosis.2014.11.018

- Erbagci AB, Tarakcioglu M, Coskun Y, Sivasli E, Sibel Namiduru E. Mediators of inflammation in children with type I diabetes mellitus: cytokines in type I diabetic children. Clinical biochemistry. 2001;34(8):645-50. DOI: https://doi.org/10.1016/S0009-9120(01)00275-2

- Kristiansen OP, Mandrup-Poulsen T. Interleukin-6 and Diabetes. The Good, the Bad, or the Indifferent? 2005;54(suppl 2): S114-S24. DOI: https://doi.org/10.2337/diabetes.54.suppl_2.S114

- Anderia G., Mauro S., Fausta N.et al. Total antioxidant capacity as a tool to assess redox status: critical view and experimental data. Bio-Assays for oxidative stress status. ELSEVIER. 2001, Pages 219–227. DOI: https://doi.org/10.1016/B978-0-444-50957-4.50035-1




How to Cite

Noor Wafaa Hashim, Kadhim Ali Kadhim, & Abbas Mahdi Rahmah. (2022). Effect of human insulin and insulin analogue on some inflammatory markers and total antioxidant capacity in a sample of Iraqi type 1 diabetic children and adolescents. Al Mustansiriyah Journal of Pharmaceutical Sciences, 21(2), 9–14. https://doi.org/10.32947/ajps.v21i2.804