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应对胰岛素储存中的挑战:医生面临的伦理困境

Addressing Challenges in Insulin Storage: An Ethical Dilemma among Physicians.

作者信息

Pande Arun K, Thakur Ashwani K, Kanchan Arvind, Srivastava Indu

机构信息

Department of Endocrinology, Lucknow Endocrine Diabetes and Thyroid Clinic, Lucknow, Uttar Pradesh, India.

Biological Sciences and Bioengineering Department, Indian Institute of Technology, Kanpur, Uttar Pradesh, India.

出版信息

Indian J Endocrinol Metab. 2023 Mar-Apr;27(2):140-144. doi: 10.4103/ijem.ijem_437_22. Epub 2023 Apr 14.

Abstract

BACKGROUND AND AIMS

Insulin is a temperature-sensitive protein; hence, its potency is highly dependent on appropriate storage. Ideally, insulin should be stored in the refrigerator, but when in use it can be stored at room temperature for up to four weeks. However, room temperatures vary widely across regions and countries, and all rural areas of developing countries like India are not electrified. This study explored physicians' perception of alternative methods for appropriate storage of insulin, such as indigenous storage methods like clay pots.

METHODS

A Study was conducted among 188 Indian physicians attending a diabetes conference in December 2018 to evaluate the feasibility of indigenous storage methods.

RESULTS

It was observed that although the use of alternate indigenous methods like clay pots was recommended by them, the proportion was low. The awareness of literature on these methods for insulin storage validation was also less than 50%. Owing to the lack of validation studies on indigenous methods, nearly 80% of the physicians felt that they were not confident to recommend them. Besides, the study results highlighted the necessity of conducting an adequate number of validation studies on indigenous methods in the Indian setting, considering their scarcity.

CONCLUSION

This is the first time we highlight ethical dilemmas through a study among physicians when they advise non-refrigerator methods for insulin storage, in the event of a lack of electricity supply. It is hoped that results from these studies would highlight ethical dilemmas among physicians and would motivate researchers in this field to conduct studies to validate alternative methods of insulin storage.

摘要

背景与目的

胰岛素是一种对温度敏感的蛋白质,因此其效力高度依赖于适当的储存条件。理想情况下,胰岛素应储存在冰箱中,但使用时可在室温下储存长达四周。然而,不同地区和国家的室温差异很大,像印度这样的发展中国家的所有农村地区都没有通电。本研究探讨了医生对胰岛素适当储存的替代方法的看法,例如陶罐等本土储存方法。

方法

2018年12月,对188名参加糖尿病会议的印度医生进行了一项研究,以评估本土储存方法的可行性。

结果

据观察,尽管他们推荐使用陶罐等替代本土方法,但比例较低。对这些胰岛素储存验证方法的文献的知晓率也不到50%。由于缺乏对本土方法的验证研究,近80%的医生表示他们没有信心推荐这些方法。此外,研究结果强调了在印度背景下对本土方法进行足够数量的验证研究的必要性,考虑到它们的稀缺性。

结论

这是我们首次通过对医生的研究强调伦理困境,即在电力供应不足的情况下,当他们建议采用非冰箱方法储存胰岛素时。希望这些研究结果能凸显医生之间的伦理困境,并激励该领域的研究人员开展研究,以验证胰岛素储存的替代方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f865/10245316/edbac4add045/IJEM-27-140-g001.jpg

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