中性原胺哈根多恩 (NPH) 胰岛素在钢笔中的悬浮不足
P M Jehle1, C Micheler, D R Jehle
1Division of Nephrology, University Hospital Ulm, Germany. peter.jehle@medizin.uni-ulm.de
Lancet (London, England)
|November 24, 1999
概括
大多数患者在笔中不充分混合中性原胺海格多恩 (NPH) 胰岛素,导致悬浮错误. 建议进行适当的混合,至少20个翻转周期,以改善糖尿病控制和减少低血糖症.
科学领域:
- 内分泌学 在内分泌学.
- 制药科学 制药科学
- 糖尿病管理 糖尿病管理
背景情况:
- 中性原胺海格多恩 (NPH) 胰岛素是一种广泛使用的通过胰岛素笔传递的中间作用胰岛素配方.
- 笔中的NPH胰岛素存在于两相溶液中,需要适当的重悬浮才能准确剂量.
- 错误的复悬浮可能导致输送胰岛素度的显著变化.
研究的目的:
- 评估使用胰岛素笔的患者对NPH胰岛素再悬浮的准确性.
- 调查NPH胰岛素悬浮错误与糖尿病患者的血糖控制之间的关联.
- 为了确定NPH胰岛素在笔子中的最佳混合技术.
主要方法:
- 109名患有糖尿病的患者在用光学系统测量卡中的NPH胰岛素含量.
- 通过问卷评估患者的胰岛素悬浮习惯.
- 患者接受了标准化的教育,通过滚动和倾倒钢笔20次来重新悬浮NPH胰岛素.
- 在3-6个月的时间里,对一小部分患者重复进行了子分析和问卷调查.
主要成果:
- 只有9%的患者进行了足够的混合 (超过十个翻转循环).
- 65%的盒子显示NPH胰岛素含量变化超过20%.
- 在教育后改善的NPH胰岛素暂停与低血糖发作显著减少相关 (p<0.05).
- 机械混合研究表明,至少需要20个循环才能完全重新悬浮.
结论:
- 在糖尿病患者中,NPH胰岛素在笔中的不充分复 suspension 是一个普遍的问题.
- 对于有效的NPH胰岛素再悬浮,建议至少进行20个翻转循环.
- 纠正悬浮错误可能有助于改善糖尿病管理,降低低血糖的风险.
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