Modified Protamine Zinc Insulin: Comparison with Globin Zinc Insulin and Insulin Mixtures1

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Abstract
In 16 direct comparative case studies, modified protamine zinc insulin (P-Z-I) gave better control in 13 patients than globin zinc insulin (G-Z-I), while only 3 diabetic patients were equally well controlled. In no case did G-Z-I establish better regulation than modified P-Z-I. G-Z-I failed to prevent after-breakfast hyperglycemia in 12 of 16 cases and caused afternoon hypoglycemia in 9 of 16. Fasting blood sugars were higher in 13 of 16 cases when G-Z-I was used. In 10 direct comparative studies with an extemporaneous mixture made with 2 parts of crystalline insulin and 1 part of P-Z-I, modified P-Z-I gave better control in every one of the 10 cases. Irregular results were obtained with the mixture, with failure to duplicate 24 hr. curves. In a total of 110 case studies conducted over a 4 yr. period, good regulation was established in 98 patients (90%) with a single inj. of MPZ insulin daily. Severe as well as mild cases were well controlled, 64% of the well regulated cases requiring over 40 units daily, some as high as 120 units (avg. 73 units).