Why the study?
What clinical factors influence the absorption of subcutaneously injected 125I-NPH insulin in diabetic patients?
What clinical factors influence the absorption of subcutaneously injected 125I-NPH insulin in diabetic patients?
Considerable inter- and intra-patient variability in NPH insulin absorption is influenced by factors like lipohypertrophy, body weight, and subcutaneous blood flow, highlighting drawbacks of conventional insulin therapy.
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May prompt site assessment in variable glycemia; leaves open whether avoiding lipohypertrophy improves NPH absorption consistency.
Clinical factors which might influence the absorption of subcutaneously injected 125I-NPH insulin were studied in 101 diabetics. The disappearance curve was monoexponential after a delay period of 1.5 +/- 0.8 h (mean +/- SD). Lipohypertrophy significantly prolonged insulin absorption (half life (T1/2) = 11.2 +/- 3.1 h, p = 0.0001). Low bicarbonate levels increased the absorption (T1/2 3.9 +/- 2.3 h, p less than 0.05). Lean diabetics had a faster absorption (6.2 +/- 1.9 h) than normal weight diabetics (7.5 +/- 2.0 h, p less than 0.02). Sex, age, diabetes duration and injection depth did not influence T1/2. The half life was significantly inversely correlated to the resting subcutaneous blood flow (r = 0.882, p less than 0.01). The overall interindividual coefficient of variation for insulin absorption in nonketotic diabetics was 27.4%. Also considerable intra-patient day-to-day variation was found (24.5%), and between different injection sites (30.2%). These variations emphasize the drawbacks of conventional insulin therapy in the management of insulin-requiring diabetics.
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Kølendorf et al. (1983) studied this question.
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