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We previously reported that in long-term studies on residual ratios of insulin added to high-calorie infusions, the ratio decreased daily in some formulations but did not in other formulations.In the present study, the reasons for the above difference were investigated by measuring long-term residual insulin ratios in specimens that contained sodium bisulfate and saccharides in the same ratios as in high-calorie infusions (Unicaliq® L. Unicaliq® N, Aminotripa® No.1 and Aminotripa® No.2), those in which glucose, fructose or xylitol was substituted for the saccharides in these infusions and those in which substitute saccharides were added in the same ratios as the saccharides in Aminotripa® No.1 and Aminotripa® No.2 (glucose : fructose : xylitol =4 : 2 : 1).The results indicated that the residual ratio of insulin added to high-calorie infusions was not influenced by types of saccharides or their combination ratios but by the relative quantities of sodium bisulfate and saccharides. The residual insulin ratio decreased when the gram amount of saccharide per 1g of sodium bisulfate (G/g) was 364.8 or below and there was a marked decrease when G/g was particularly small. There was no decrease in residual insulin ratio when G/g was 466.0 or above.The above results could be used as reference indices in the selection of high-calorie infusions for HPN that will demonstrate high stability when insulin is added.

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Prescription Design for Total Parenteral Nutrition for HPN (V)-Effects of Sodium Bisulfate and Saccharides on Residual Insulin Ratio in High-Calorie Infusions-.