Playán J, Acha J, Navarro H, Sanz A, Guallar A M, Albero R
Servicio de Endocrinología, Hospital Miguel Servet, Zaragoza.
Rev Clin Esp. 1994 Jan;194(1):20-2.
In the past decade, human insulins have been substituting animal insulins, offering the advantage of its lesser antigenic capacity. One of the most clinically important problems with human NPH insulins is its tendency to flocculate. We present four diabetic patients who, after using flocculated human NPH insulin, encountered a deterioration in the metabolic control of their diabetes, and in two of them, there were bouts of diabetic Ketoacidosis "without any other apparent causal factors". Among those causes favoring flocculation are movement during transport, high temperatures, and probably leaving the vial open for an excessively long period of time, as with the extraction of multiple doses. Physicians, educators, diabetics, and their relatives should be informed of this phenomenon. Diabetics, especially those who carry insulin with them, should carefully inspect their vials before each injection to detect signs of flocculation.
在过去十年中，人胰岛素一直在替代动物胰岛素，其优势在于抗原性较弱。人NPH胰岛素临床上最重要的问题之一是其絮凝倾向。我们报告了四名糖尿病患者，他们在使用了絮凝的人NPH胰岛素后，糖尿病的代谢控制出现恶化，其中两名患者还出现了“无任何其他明显病因”的糖尿病酮症酸中毒发作。促使絮凝的因素包括运输过程中的晃动、高温，以及可能像多次抽取剂量那样长时间打开药瓶。应告知医生、教育工作者、糖尿病患者及其亲属这一现象。糖尿病患者，尤其是随身携带胰岛素的患者，每次注射前都应仔细检查药瓶，以发现絮凝迹象。
