Heinemann (1) has addressed this issue in detail; his discussion reviews the salient points regarding this highly confusing topic. The vagaries he outlines subsume the reasons that have consistently driven us to strongly recommend the use of SI units for reporting insulin concentrations. Within the work as described in our publications (2,3), we used recombinant DNA-derived human insulin (generously provided by Novo Nordisk Pharmaceuticals and Eli Lilly and Company), which was carefully weighed (in mg or μg) or prepared from preweighed lyophilized material, to yield amounts in solution to provide values in concentrations of pmol/l for immunoassay calibrators or standards. Thus, we were able to use the molecular weight of insulin (5,808 Da) to yield an insulin concentration in SI units. Several people collaborating with us on both our articles had extensive experience with insulin assays, especially in industry, and worked with us to make sure we used what was considered to be the appropriate conversion factor: 1 μU/ml insulin = 6 pmol/l (4). Although the numerical conversion is 6, we differ in units from Heinemann, who used 1 μU/ml insulin = 6 nmol/l.

Overall, we did discuss the choices for numerical conversion factors. In the end, we continue to advocate the use of SI units to express the circulating concentrations of both insulin and C-peptide concentrations.

No potential conflicts of interest relevant to this article were reported.

1.
Heinemann
L
:
Insulin Assay Standardization: leading to measures of insulin sensitivity and secretion for practical clinical care: response to Staten et al (Letter)
.
Diabetes Care
2010
;
33
:
e83
.
2.
Marcovina
S
,
Bowsher
RR
,
Miller
WG
,
Staten
M
,
Myers
G
,
Caudill
SP
,
Campbell
SE
,
Steffes
MW
:
Insulin Standardization Workgroup
.
Standardization of Insulin Immunoassays: report of the American Diabetes Association Workgroup
.
Clin Chem
2007
;
53
:
711
716
3.
Miller
WG
,
Thienpont
LM
,
Van Uytfanghe
K
,
Clark
PM
,
Lindstedt
P
,
Nilsson
G
,
Steffes
MW
:
Insulin Standardization Work Group
.
Toward standardization of insulin immunoassays
.
Clin Chem
2009
;
55
:
1011
1018
4.
Vølund
A
,
Brange
J
,
Drejer
K
,
Jensen
I
,
Markussen
J
,
Ribel
U
,
Sørensen
AR
,
Schlichtkrull
J
:
In vitro and in vivo potency of insulin analogues designed for clinical use
.
Diabet Med
1991
;
8
:
839
847
Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. See http://creativecommons.org/licenses/by-nc-nd/3.0/ for details.