One in five (21%) of the correspondents wrote of a return to animal based insulin with an improvement in the condition of the person with diabetes. Only 1% said there had been no improvement when they changed back to animal based insulin.

While I was on human insulin, my life was absolute hell. There was absolutely no warning of my blood sugar levels going low, and I have been in several comas because of this… my diabetic clinic put me back on to animal insulin in July and I've felt a different person since…No.144

For the past four months I have been on the pork insulin and am beginning to feel my old self once again. The change is remarkable. No.157

Having suffered many problems years on human insulin, I recently changed back to pork insulin, with immediate improved diabetic control and far superior quality of life for myself and my family. Further more, I consider my chances of survival, particularly whilst driving, improved beyond recognition. No. 301

The change in my condition since… I reverted back has been remarkable. I get normal hypo conditions where I can balance my stability. My concentration and awareness have greatly improved. I am in no doubt that the troubles, and wasted years of my life were due to human insulin. No. 308

TABLE

Numbers Return to 'animal' insulin with improvement 79 Return to 'animal' insulin without improvement 4 OK on 'human' insulin 12

In three percent of the letters, it was noted that the change-over to genetically engineered insulin had caused no problems though adjustment may have been necessary. One of these correspondents wrote that the new insulin had a "fierce but efficient response to sugar".

THE MEDIA'S INFLUENCE

Over a fifth of correspondents mentioned an item in the media which related to their concerns. A television programme or news item was mentioned twice as often as articles in newspapers or magazines. Occasionally an item on the radio programme was mentioned. This data by itself does not allow a complete analysis of the role of the media in the development of the issues, but the effects of this media coverage apparent fro the letters examined, were to inform, to alarm and to bring people together.

In the first place, people learnt that they were a number of IDD's having difficulties with the transfer to genetically engineered insulin, and that there was a common core to these difficulties, namely loss of warning signs of hypoglycaemia. This knowledge put their own experiences and concerns in a different context if these had been dismissed by their doctors. They were no longer the only one complaining- the odd or awkward one out. They were part of a sizeable minority with similar difficulties trying to get the problems recognised and to do something about it.

Often it was clear that letters had been prompted by this media coverage and this meant that more people were in contact with the BDA than would otherwise have the case. This opened a two way channel of communication. It enabled the BDA to acquire a wider view of the problem by receiving information about a greater number of people's experiences, and it allowed the BDA to give information and advice to more people.

People were brought together to joint legal action, and in a new pressure group called the 'National Diabetics Federation' and of course via the BDA. Some people wrote to the BDA with a view to making a claim asking how to get in touch with the relevant lawyers. In general, however, people wrote because they wanted to share their experiences with other people with diabetes, because they wanted to be 'counted' and because they wanted the BDA's recognition and support through understanding, advice and influence on their behalf. On occasion, people wrote to complain about the BDA's apparent stance or coverage of the problem.

"Exactly what is going on here?" asked one member. "I think you are looking but you are not seeing, and you are listening but you are not hearing what is being said to you." (No. 319)