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In recent years estrogens, either alone or with progestins in a sequential dosage schedule, have been introduced in the hormonal substitution treatment of post-menopausal women. Synthetic estrogen-progestin combinations given for contraceptive purposes are known to cause certain metabolic alterations (for a recent review see, e.g. Spellacy1). These include an increase in the fasting plasma insulin level and an increase in the plasma insulin response after glucose load. An increase in the serum triglyceride level is found almost without exception in women taking oral contraceptives. Alterations in serum cholesterol levels are less consistent.

During 1979 sufficient amounts of ‘semi-synthetic’ human insulin produced by enzymatic conversion of porcine insulin (Markussen, 1980) became available for pre-clinical toxicity and general pharmacological studies in animals. No real difference was found between the effects of human and porcine insulin (Gamst-Andersen et al, 1983; Jorgensen et al, 1983). Following the satisfactory completion of these studies, human insulin prepared to monocomponent specifications (Schlichtkrull et al, 1970, 1974) became available for clinical evaluation during August 1980.