Carrier solutions for low-level intravenous insulin infusion.

Kraegen, E.W.; Lazarus, L.; Meler, H.; Campbell, Lesley V.; Chia, Yen Lin

doi:10.1136/bmj.3.5981.464

Cited by 66 publications

(22 citation statements)

References 8 publications

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“…Infusions consisted of 1) placebo (Gelofusine), 2) GLP-1 7-36 amide (0.4 pmol/kg/min; Clinalfa Basic, Bachem, Switzerland), 3) glucagon (2.8 pmol/kg/min; Novo Nordisk, Crawley, U.K.), or 4) combined GLP-1 and glucagon at the above doses. Gelofusine was used as the vehicle for hormone infusions in order to minimize adsorption of peptides to infusion lines and syringes (26).…”

Section: Methodsmentioning

confidence: 99%

Coinfusion of Low-Dose GLP-1 and Glucagon in Man Results in a Reduction in Food Intake

et al. 2014

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Obesity is a growing epidemic, and current medical therapies have proven inadequate. Endogenous satiety hormones provide an attractive target for the development of drugs that aim to cause effective weight loss with minimal side effects. Both glucagon and GLP-1 reduce appetite and cause weight loss. Additionally, glucagon increases energy expenditure. We hypothesized that the combination of both peptides, administered at doses that are individually subanorectic, would reduce appetite, while GLP-1 would protect against the hyperglycemic effect of glucagon. In this double-blind crossover study, subanorectic doses of each peptide alone, both peptides in combination, or placebo was infused into 13 human volunteers for 120 min. An ad libitum meal was provided after 90 min, and calorie intake determined. Resting energy expenditure was measured by indirect calorimetry at baseline and during infusion. Glucagon or GLP-1, given individually at subanorectic doses, did not significantly reduce food intake. Coinfusion at the same doses led to a significant reduction in food intake of 13%. Furthermore, the addition of GLP-1 protected against glucagon-induced hyperglycemia, and an increase in energy expenditure of 53 kcal/day was seen on coinfusion. These observations support the concept of GLP-1 and glucagon dual agonism as a possible treatment for obesity and diabetes.

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Section: Methodsmentioning

confidence: 99%

Coinfusion of Low-Dose GLP-1 and Glucagon in Man Results in a Reduction in Food Intake

et al. 2014

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“…5,[7][8][9] Different strategies have been proposed to minimize insulin adsorption. Priming tubing with albumin or whole blood prior to initiating an insulin infusion decreases adsorption 5,10,11 ; however, this method unnecessarily exposes patients to blood products. Insulin adsorption can also be decreased by infusing insulin solutions with a higher concentration or at higher rates.…”

Section: Introductionmentioning

confidence: 99%

The Effect of Tubing Dwell Time on Insulin Adsorption During Intravenous Insulin Infusions

Thompson

Vital-Carona

Faustino

2012

Diabetes Technology & Therapeutics

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Background: Insulin adsorbs to plastic tubing, which decreases the concentration of an insulin solution delivered from an intravenous infusion set. Dwelling insulin within tubing before starting the infusion decreases adsorption but delays treatment initiation and wastes time in infusion preparation. The lack of data on dwell time effects results in wide variability in practice. We aim to determine the effect of dwell time on insulin concentration from intravenous infusion tubing. Materials and Methods: In this in vitro study, we used insulin solutions with concentrations of 0.1 unit/mL, 1 unit/mL, and 10 units/mL. Each solution dwelled in intravenous infusion sets for 0, 15, 30, or 60 min. After the dwell, we measured insulin concentrations from the solution bags and tubing. We repeated each insulin concentration-dwell time combination five times. Comparisons were performed using analyses of variance. Results: For each of the three insulin concentrations, the mean insulin concentrations from the tubing were not significantly different between dwell times. Duration of dwell time did not affect insulin adsorption in polypropylene intravenous infusion sets. Conclusions: We recommend that following a 20-mL flush, insulin infusions can be started without any dwell time. Removal of dwell times may improve clinical practice by minimizing preparation time and will allow faster initiation of insulin infusion therapy.

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“…33 The use of excipients such as human serum albumin, glycerol, trehalose or surfactants, as well as polymer carriers in protein product formulations has also been employed. [34][35][36][37] The excipients used to prevent or reduce adsorption are either more surfaceactive than the protein, thus preferentially adsorbing at interfaces, or act as competitive inhibitors of adsorption. 2 For example, the conventional surfactants used in protein formulations are typically small non-ionic surfactants that either occupy the interface by direct competition with the protein, form surfactant-protein complexes that are less surface-interactive and thus remain in solution, or a combination of both.…”

Section: Discussionmentioning

confidence: 99%

Development of a stable low-dose aglycosylated antibody formulation to minimize protein loss during intravenous administration

Morar-Mitrica

Puri

Sassi

et al. 2015

mAbs

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The physical and chemical integrity of a biopharmaceutical must be maintained not only during long-term storage but also during administration. Specifically for the intravenous (i.v.) delivery of a protein drug, loss of stability can occur when the protein formulation is compounded with i.v. bag diluents, thus modifying the original composition of the drug product. Here we present the challenges associated with the delivery of a low-dose, highly potent monoclonal antibody (mAb) via the i.v. route. Through parallel in-use stability studies and conventional formulation development, a drug product was developed in which adsorptive losses and critical oxidative degradation pathways were effectively controlled. This development approach enabled the i.v. administration of clinical doses in the range of 0.1 to 0.5 mg total protein, while ensuring liquid drug product storage stability under refrigerated conditions.

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Carrier solutions for low-level intravenous insulin infusion.

Cited by 66 publications

References 8 publications

Coinfusion of Low-Dose GLP-1 and Glucagon in Man Results in a Reduction in Food Intake

Coinfusion of Low-Dose GLP-1 and Glucagon in Man Results in a Reduction in Food Intake

The Effect of Tubing Dwell Time on Insulin Adsorption During Intravenous Insulin Infusions

Development of a stable low-dose aglycosylated antibody formulation to minimize protein loss during intravenous administration

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