Effect of mixing short-and intermediate (NPH insulin or Zn insulin suspension) -acting human insulin on plasma free insulin levels and action profiles.
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To examine the assumption that the absorption kinetics of soluble short-acting insulin are not influenced by mixing with insoluble long-acting insulin, we used human insulins from three manufactures to determine the recovery of short-acting insulin when mixed with the respective company's intermediate-acting insulin (NPH insulin or Z<SUB>n</SUB>, insulin suspension) as a function of the time of premixing. Plasma free insulin profiles after the injection of insulin mixtures were compared with those after separate injections of short-acting and intermediate-acting insulin in diabetic patients.<BR>1. Short-acting insulin showed a significant loss of solubility when mixed with a Z, insulin suspension, even when assayed immediately after mixing. On the other hand, a slight but statistically significant loss of solubility was observed when it was mixed with NPH insulin either 5 min or 2 weeks before centrifugation.<BR>2. With a time lag of 5 min between the mixing of short-acting insulin and Z<SUB>n</SUB>, insulin suspension, injection caused a delayed rise and a significantly lower peak value of plasma free insulin levels. In contrast, the delay and lower peak of plasma free insulin levels were not observed when short-acting insulin and NPH insulin were mixed either 5 min or 2 weeks before injection. Plasma free insulin profiles after injection of the mixture were almost the same as those after separate injections.<BR>3. The post-prandial glycemic rise, as determined by the integrated area under the curve (ΣΔBG for 2 hrs), for the injected insulin mixture of Z<SUB>n</SUB> insulin suspension was significantly higher than that for separate injections, but this was not observed with the insulin mixture of NPH insulin.<BR>From these findings, it is recommended that in multiple insulin injection therapy, short-acting human insulin should be mixed with the respective company's intermediate-acting human NPH insulin.
- 一般社団法人 日本糖尿病学会の論文
一般社団法人 日本糖尿病学会 | 論文
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