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Addition of regular insulin to ternary parenteral nutrition: a stability study

Abstract : 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 (r2p CONCLUSIONS: 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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Soumis le : mercredi 19 janvier 2022 - 09:57:18
Dernière modification le : mercredi 11 mai 2022 - 12:32:01

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Héloïse Henry, Damien Lannoy, Patrice Maboudou, David Seguy, Thierry Dine, et al.. Addition of regular insulin to ternary parenteral nutrition: a stability study. Pharmaceutics, MDPI, 2021, Pharmaceutics, 13 (4), pp.458. ⟨10.3390/pharmaceutics13040458⟩. ⟨hal-03533884⟩



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