Metabolism of human insulin after subcutaneous administration: A possible means to uncover insulin misuse

Thomas, Andreas; Brinkkötter, Paul; Schänzer, Wilhelm; Thevis, Mario

doi:10.1016/j.aca.2015.09.036

Cited by 23 publications

(14 citation statements)

References 37 publications

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“…Accordingly, the incidence of DM complications can rise significantly leading to mortality [ 16 ]. Therefore, it is crucial to understand the practices of DM patients toward their insulin injection technique [ 14 ].…”

Section: Discussionmentioning

confidence: 99%

Assessment of Insulin Injection Technique Among Diabetic Patients in Makkah Region in Saudi Arabia

Alhazmi¹,

Balubaid²,

Sajiny³

et al. 2020

Cureus

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Introduction: Diabetes mellitus (DM) is defined as a chronic metabolic disorder characterized by persistent high blood glucose. Proper insulin injection is indispensable to achieve adequate control of DM and prevent complications. Therefore, this study aims to assess the knowledge of DM patients about their insulin injection techniques. Materials and Methods: A questionnaire-based and cross-sectional study was carried out from January to March 2020 at three locations in Makkah, Saudi Arabia. The inclusion criteria of research subjects included patients diagnosed with type-1 or type-2 DM and using insulin pen injection. The questionnaire included demographic data including age, gender, nationality, educational level, and chronic disease as well as specific questions about insulin injection technique. Results: Four hundred and thirty-seven DM patients participated in the study. The most prevalent age group was between 20 and 60 years old (69.1%). The vast majority of patients were females (64.1%), Saudi nationals (92.9%), and residents of Makkah city (70%). There were roughly equal numbers of patients with type-1 and type-2 DM (47% and 53%, respectively). With regard to complications of DM, 19.5% of patients had previous acidosis, and 16.5% of patients were admitted to hospital for various complications. Injection-related complications were reported by almost half of the patients (49.9). The knowledge of insulin injection practices was examined among DM patients according to different variables. Only the frequency of administration exhibited a significant difference in the practices toward proper insulin injection technique (p = 0.049); patients who administered insulin injection three times daily had the best practices toward insulin injection when compared to other patients. Conclusions: Our study showed that the practices toward insulin use among the surveyed DM patients in Makkah region were not satisfactory. Poor insulin injection technique is an important modifiable risk factor for uncontrolled blood glucose levels. More awareness campaigns and better counseling initiatives are crucial to guarantee steady insulin levels among DM patients.

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Section: Discussionmentioning

confidence: 99%

Assessment of Insulin Injection Technique Among Diabetic Patients in Makkah Region in Saudi Arabia

Alhazmi¹,

Balubaid²,

Sajiny³

et al. 2020

Cureus

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“…For the investigation of the metabolic fate of GHRHs, in vitro experiments using fresh human plasma samples were conducted, allowing to test for potential degradation products of the studied substances. In accordance to earlier reported methods [ 23 ], aliquots of human plasma samples were diluted (1:1) with PBS [ 22 ] and spiked to 10 μg/mL with Sermorelin or Tesamorelin, respectively. After incubation for 30, 60, 120, and 240 min at 37 °C, samples were prepared and analyzed as described elsewhere [ 20 ].…”

Section: Methodsmentioning

confidence: 99%

Qualitative identification of growth hormone-releasing hormones in human plasma by means of immunoaffinity purification and LC-HRMS/MS

et al. 2016

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The use of growth hormone-releasing hormones (GHRHs) is prohibited in sports according to the regulations of the World Anti-Doping Agency (WADA). The aim of the present study was to develop a method for the simultaneous detection of four different GHRHs and respective metabolites from human plasma by means of immunoaffinity purification and subsequent nano-ultrahigh performance liquid chromatography-high resolution/high accuracy (tandem) mass spectrometry. The target analytes included Geref (Sermorelin), CJC-1293, CJC-1295, and Egrifta (Tesamorelin) as well as two metabolites of Geref and CJC-1293, which were captured from plasma samples using a polyclonal GHRH antibody in concert with protein A/G monolithic MSIA™ D.A.R.T.’S® (Disposable Automation Research Tips) prior to separation and detection. The method was fully validated and found to be fit for purpose considering the parameters specificity, linearity, recovery (19–37 %), lower limit of detection (<50 pg/mL), imprecision (<20 %), and ion suppression/enhancement effects. The analytes’ stability and metabolism were elucidated using in vitro and in vivo approaches. EDTA blood samples were collected from rats 2, 4, and 8 h after intravenous administration of GHRH (one compound per test animal). All intact substances were detected for at least 4 h but no anticipated metabolite was confirmed in laboratory rodents’ samples; conversely, a Geref metabolite (GHRH3-29) was found in a human plasma sample collected after subcutaneous injection of the drug to a healthy male volunteer. The obtained results demonstrate that GHRHs are successfully detected in plasma using an immunoaffinity-mass spectrometry-based method, which can be applied to sports drug testing samples. Further studies are however required and warranted to account for potential species-related differences in metabolism and elimination of the target analytesGraphical abstractGHRH immunoaffinity purification by means of anti-GHRH antibody coated protein A/G D.A.R.T.’S

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“…Aiming at establishing a profile of insulin and its precursor and/or metabolite(s) indicative for subcutaneous insulin administration, Thomas et al . studied the metabolism of insulin caused by epidermal proteases as well as blood samples collected from healthy individuals and insulin‐dependent diabetics . DesB30 human insulin, formerly reported as degradation product found also in human urine, was found to exclusively exist in plasma of individuals having received s .…”

Section: Anabolic Agentsmentioning

confidence: 99%

“…Aiming at establishing a profile of insulin and its precursor and/or metabolite(s) indicative for subcutaneous insulin administration, Thomas et al studied the metabolism of insulin caused by epidermal proteases as well as blood samples collected from healthy individuals and insulin-dependent diabetics. [123] DesB30 human insulin, formerly reported as degradation product found also in human urine, was found to exclusively exist in plasma of individuals having received s.c. injections of human insulin, thus representing a viable marker for surreptitious insulin administrations. Following dilution and ultracentrifugation, human insulin and its metabolic products were isolated from plasma using established immunoaffinity purification protocols, and target analytes were measured using nanoLC-HRMS to allow for LODs of 50 pg/mL.…”

Section: Hormone and Metabolic Modulatorsmentioning

confidence: 99%

Annual banned‐substance review: analytical approaches in human sports drug testing

Thevis

Kuuranne

Geyer

et al. 2017

Drug Testing and Analysis

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There has been an immense amount of visibility of doping issues on the international stage over the past 12 months with the complexity of doping controls reiterated on various occasions. Hence, analytical test methods continuously being updated, expanded, and improved to provide specific, sensitive, and comprehensive test results in line with the World Anti-Doping Agency's (WADA) 2016 Prohibited List represent one of several critical cornerstones of doping controls. This enterprise necessitates expediting the (combined) exploitation of newly generated information on novel and/or superior target analytes for sports drug testing assays, drug elimination profiles, alternative test matrices, and recent advances in instrumental developments. This paper is a continuation of the series of annual banned-substance reviews appraising the literature published between October 2015 and September 2016 concerning human sports drug testing in the context of WADA's 2016 Prohibited List. Copyright © 2016 John Wiley & Sons, Ltd.

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Metabolism of human insulin after subcutaneous administration: A possible means to uncover insulin misuse

Cited by 23 publications

References 37 publications

Assessment of Insulin Injection Technique Among Diabetic Patients in Makkah Region in Saudi Arabia

Assessment of Insulin Injection Technique Among Diabetic Patients in Makkah Region in Saudi Arabia

Qualitative identification of growth hormone-releasing hormones in human plasma by means of immunoaffinity purification and LC-HRMS/MS

Annual banned‐substance review: analytical approaches in human sports drug testing

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