Is insulin diluted when stored in water?

Phillip Plager, Kadiro Nurie, Trevor Omann, Antoinette Moran, Thereza Piloya, Silver Bahendeka, Muna Sunni

Research output: Contribution to journalArticle

Abstract

Background: Insulin storage is a challenge in resource-poor countries. In Uganda, patients were noted to store insulin vials by submerging them in water. Objective: To examine whether withdrawing insulin from a vial without adding air back causes a vacuum which allows water to enter the vial, resulting in insulin dilution. Methods: Seven hundred units of insulin were withdrawn from forty 10 mL vials of 100 units/mL insulin [20 neutral protamine hagedorn (NPH), 20 regular]. In half, air was added back. The vials were weighed (baseline). Half of the vials (10 with added air, 10 without) were submerged in water for 24 h and then air-dried for 24 h. Vials that were not submerged sat at room temperature for 48 h. All vials were weighed 48 h from baseline. Results: Addition of air did not impact the change in weight after submersion (air added: −0.002 ± 0.001 g or −0.2 ± 0.1 unit; no air added: −0.003 ± 0.000 g or −0.3 ± 0 unit, p = 0.57). In a subset of vials in which an additional 240 units were withdrawn before submersion for another 24 h, there was still no difference in weight change in those vials with air added (p = 0.2). Conclusion: Withdrawing insulin from a vial without adding air did not result in uptake of water or dilution of insulin in the submerged vial, although it made drawing up the insulin easier. This study did not address the larger concern of bacterial contamination of the rubber stopper during water storage.

Original languageEnglish (US)
Pages (from-to)237-240
Number of pages4
JournalPediatric Diabetes
Volume18
Issue number3
DOIs
StatePublished - May 1 2017

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Air
Insulin
Water
Immersion
Isophane Insulin
Weights and Measures
Uganda
Rubber
Vacuum
Temperature

Keywords

  • insulin dilution
  • insulin storage
  • submerged insulin

PubMed: MeSH publication types

  • Comparative Study
  • Journal Article

Cite this

Plager, P., Nurie, K., Omann, T., Moran, A., Piloya, T., Bahendeka, S., & Sunni, M. (2017). Is insulin diluted when stored in water? Pediatric Diabetes, 18(3), 237-240. https://doi.org/10.1111/pedi.12367

Is insulin diluted when stored in water? / Plager, Phillip; Nurie, Kadiro; Omann, Trevor; Moran, Antoinette; Piloya, Thereza; Bahendeka, Silver; Sunni, Muna.

In: Pediatric Diabetes, Vol. 18, No. 3, 01.05.2017, p. 237-240.

Research output: Contribution to journalArticle

Plager, P, Nurie, K, Omann, T, Moran, A, Piloya, T, Bahendeka, S & Sunni, M 2017, 'Is insulin diluted when stored in water?', Pediatric Diabetes, vol. 18, no. 3, pp. 237-240. https://doi.org/10.1111/pedi.12367
Plager P, Nurie K, Omann T, Moran A, Piloya T, Bahendeka S et al. Is insulin diluted when stored in water? Pediatric Diabetes. 2017 May 1;18(3):237-240. https://doi.org/10.1111/pedi.12367
Plager, Phillip ; Nurie, Kadiro ; Omann, Trevor ; Moran, Antoinette ; Piloya, Thereza ; Bahendeka, Silver ; Sunni, Muna. / Is insulin diluted when stored in water?. In: Pediatric Diabetes. 2017 ; Vol. 18, No. 3. pp. 237-240.
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AB - Background: Insulin storage is a challenge in resource-poor countries. In Uganda, patients were noted to store insulin vials by submerging them in water. Objective: To examine whether withdrawing insulin from a vial without adding air back causes a vacuum which allows water to enter the vial, resulting in insulin dilution. Methods: Seven hundred units of insulin were withdrawn from forty 10 mL vials of 100 units/mL insulin [20 neutral protamine hagedorn (NPH), 20 regular]. In half, air was added back. The vials were weighed (baseline). Half of the vials (10 with added air, 10 without) were submerged in water for 24 h and then air-dried for 24 h. Vials that were not submerged sat at room temperature for 48 h. All vials were weighed 48 h from baseline. Results: Addition of air did not impact the change in weight after submersion (air added: −0.002 ± 0.001 g or −0.2 ± 0.1 unit; no air added: −0.003 ± 0.000 g or −0.3 ± 0 unit, p = 0.57). In a subset of vials in which an additional 240 units were withdrawn before submersion for another 24 h, there was still no difference in weight change in those vials with air added (p = 0.2). Conclusion: Withdrawing insulin from a vial without adding air did not result in uptake of water or dilution of insulin in the submerged vial, although it made drawing up the insulin easier. This study did not address the larger concern of bacterial contamination of the rubber stopper during water storage.

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