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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...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2021
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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. |
format | Online Article Text |
id | pubmed-8066181 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
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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