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Addition of Regular Insulin to Ternary Parenteral Nutrition: A Stability Study

Background: Parenteral nutrition (PN) is a complex medium in which added insulin can become unstable. The aim of this study is, therefore, to evaluate the stability of insulin in PN and to identify influencing factors. Methods: A total of 20 IU/L of regular insulin was added to PN in either glass or...

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Autores principales: Henry, Heloise, Lannoy, Damien, Maboudou, Patrice, Seguy, David, Dine, Thierry, Pigny, Pascal, Odou, Pascal
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8066181/
https://www.ncbi.nlm.nih.gov/pubmed/33801784
http://dx.doi.org/10.3390/pharmaceutics13040458
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author Henry, Heloise
Lannoy, Damien
Maboudou, Patrice
Seguy, David
Dine, Thierry
Pigny, Pascal
Odou, Pascal
author_facet Henry, Heloise
Lannoy, Damien
Maboudou, Patrice
Seguy, David
Dine, Thierry
Pigny, Pascal
Odou, Pascal
author_sort Henry, Heloise
collection PubMed
description Background: Parenteral nutrition (PN) is a complex medium in which added insulin can become unstable. The aim of this study is, therefore, to evaluate the stability of insulin in PN and to identify influencing factors. Methods: A total of 20 IU/L of regular insulin was added to PN in either glass or Ethylene Vinyl Acetate (EVA) containers. A 24 h stability study was performed via an electrochemiluminescence immunoassay in different media: A ternary PN admixture, separate compartments of the PN bag and a binary admixture. This study was repeated in the absence of zinc, with the addition of serum albumin or tween and with pH adjustment (3.6 or 6.3). Insulin concentration at t time was expressed as a percentage of the initial insulin concentration. Analysis of covariance (ANCOVA) was applied to determine the factors that influence insulin stability. Results: In all PN admixtures, the insulin concentration ratio decreased, stabilising at a 60% and then plateauing after 6 h. At pH 3.6, the ratio was above 90%, while at pH 6.3 it decreased, except in the amino acid solution. ANCOVA (r(2) = 0.68, p = 0.01) identified dextrose and pH as significant factors influencing insulin stability. Conclusion: A low pH level seems to stabilise insulin in PN admixtures. The influence of dextrose content suggests that insulin glycation may influence stability.
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spelling pubmed-80661812021-04-25 Addition of Regular Insulin to Ternary Parenteral Nutrition: A Stability Study Henry, Heloise Lannoy, Damien Maboudou, Patrice Seguy, David Dine, Thierry Pigny, Pascal Odou, Pascal Pharmaceutics Article Background: Parenteral nutrition (PN) is a complex medium in which added insulin can become unstable. The aim of this study is, therefore, to evaluate the stability of insulin in PN and to identify influencing factors. Methods: A total of 20 IU/L of regular insulin was added to PN in either glass or Ethylene Vinyl Acetate (EVA) containers. A 24 h stability study was performed via an electrochemiluminescence immunoassay in different media: A ternary PN admixture, separate compartments of the PN bag and a binary admixture. This study was repeated in the absence of zinc, with the addition of serum albumin or tween and with pH adjustment (3.6 or 6.3). Insulin concentration at t time was expressed as a percentage of the initial insulin concentration. Analysis of covariance (ANCOVA) was applied to determine the factors that influence insulin stability. Results: In all PN admixtures, the insulin concentration ratio decreased, stabilising at a 60% and then plateauing after 6 h. At pH 3.6, the ratio was above 90%, while at pH 6.3 it decreased, except in the amino acid solution. ANCOVA (r(2) = 0.68, p = 0.01) identified dextrose and pH as significant factors influencing insulin stability. Conclusion: A low pH level seems to stabilise insulin in PN admixtures. The influence of dextrose content suggests that insulin glycation may influence stability. MDPI 2021-03-27 /pmc/articles/PMC8066181/ /pubmed/33801784 http://dx.doi.org/10.3390/pharmaceutics13040458 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) ).
spellingShingle Article
Henry, Heloise
Lannoy, Damien
Maboudou, Patrice
Seguy, David
Dine, Thierry
Pigny, Pascal
Odou, Pascal
Addition of Regular Insulin to Ternary Parenteral Nutrition: A Stability Study
title Addition of Regular Insulin to Ternary Parenteral Nutrition: A Stability Study
title_full Addition of Regular Insulin to Ternary Parenteral Nutrition: A Stability Study
title_fullStr Addition of Regular Insulin to Ternary Parenteral Nutrition: A Stability Study
title_full_unstemmed Addition of Regular Insulin to Ternary Parenteral Nutrition: A Stability Study
title_short Addition of Regular Insulin to Ternary Parenteral Nutrition: A Stability Study
title_sort addition of regular insulin to ternary parenteral nutrition: a stability study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8066181/
https://www.ncbi.nlm.nih.gov/pubmed/33801784
http://dx.doi.org/10.3390/pharmaceutics13040458
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