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[Loss of insulin during the infusion of insulin in glucose and nutrient solutions]
Controversial results of previous investigations prompted us to reassess the adsorptive loss of insulin to infusion bottles and tubings. An experimental array was chosen which was in strict accordance with the infusion technique used for the high-caloric parenteral nutrition of severely ill patients. The insulin concentrations were determined by a radioimmunoassay method. As in pure glucose solutions of various concentrations a loss of insulin amounting to about 30% was determined in high-caloric solutions containing aminoacids. The protective effect of human serum albumin, gelatine (Physiogel), and Rheomakrodex, all three of which diminish the insulin loss by about 50%, could be confirmed. The varying results obtained by different investigators may be attributable mainly to technical factors such as different surface properties of the infusion material, differences of the experimental array and analytical methods. Accordingly, variable losses of insulin may also occur in clinical practice. For daily routine an exact knowledge of these losses is irrelevant, since the insulin dosage is adjusted to the blood sugar level. However, if the insulin requirement is used as an index of the metabolic condition of the patient, precise determination of the actual loss is mandatory.
Controversial results of previous investigations prompted us to reassess the adsorptive loss of insulin to infusion bottles and tubings. An experimental array was chosen which was in strict accordance with the infusion technique used for the high-caloric parenteral nutrition of severely ill patients. The insulin concentrations were determined by a radioimmunoassay method. As in pure glucose solutions of various concentrations a loss of insulin amounting to about 30% was determined in high-caloric solutions containing aminoacids. The protective effect of human serum albumin, gelatine (Physiogel), and Rheomakrodex, all three of which diminish the insulin loss by about 50%, could be confirmed. The varying results obtained by different investigators may be attributable mainly to technical factors such as different surface properties of the infusion material, differences of the experimental array and analytical methods. Accordingly, variable losses of insulin may also occur in clinical practice. For daily routine an exact knowledge of these losses is irrelevant, since the insulin dosage is adjusted to the blood sugar level. However, if the insulin requirement is used as an index of the metabolic condition of the patient, precise determination of the actual loss is mandatory.