Biosulin® P (Biosulin R)

Biosulin P magani ne wanda yake nuna rashin lafiyar ɗan adam wanda yake yin aiki kaɗan. An samo wannan insulin ne ta injiniyan kwayoyin, sakamakon shi, bisa ga rarrabuwa, Biosulin P ya kasance rukuni ne na inginin ɗan adam.

Zafin farawa yana faruwa ne bayan minti 30-60 kuma ana lura dashi tsawon awanni 6-8.

Ana samun masu karɓar insulin a cikin jiki duka saboda yana haɗuwa da kusan dukkanin matakai na rayuwa kuma yana haifar da adadin halayen ɗimbin ƙwayoyin ciki. Amma manyan gabobin don insulin sune hanta, tsokoki da tsoka nama. Tasirin halittar insulin:

• tsari na metabolism metabolism a sakamakon karuwar sufuri da kuma amfani da glucose ta sel, saboda abin da aka kirkiro glycogen,
• toshewar kwayar cutar glucose ta ciki saboda hanawar glycogen gushewa da kuma rage samar da glucose daga wasu hanyoyin,
• Kasancewa cikin metabolism na kitse, wanda aka nuna da raguwa a cikin kitsersu, wanda ke haifar da raguwa a cikin ci gaba da yawan kitse mai kyauta a cikin jini,
• tarewa tare da samuwar ketones,
• increasedarin haɓakar mai mai mai yawa tare da kasancewarta ta gaba, saboda abin da ake kafa coenzyme mai mahimmanci a cikin jikin mutum,
• Kasancewar metabolism, wanda ya kunshi kara jigilar jigilar amino a cikin sel, karfafa samar da peptides, rage yawan kuzarin ta hanyar kyallen takarda, da kuma hana samuwar keto acid daga amino acid.
• kunnawa ko hanawa wasu nau'ikan enzymes.

Insulins sune ainihin hanyar maye gurbin jiyya don lura da ciwon sukari. Zabi na miyagun ƙwayoyi ya dogara da tsananin da halayen cutar, yanayin mai haƙuri da gudu da tsawon lokacin sakamako na hypoglycemic. Ana gudanar da jiyya ne gwargwadon tsarin mutum, wanda aka haɗa shirye-shiryen insulin daban-daban na ayyukan yau da kullun.

Tsarin rage cin abinci lokacin amfani da insulin yakamata ya iyakance ta ƙimar abinci daga 1700 zuwa 3000 kcal.

Lokacin zabar sashi, ana auna sukari na jini da fitsari a kan komai a ciki kuma a ko'ina cikin rana. Determinationarshe na ƙarshe yana ƙarƙashin rage hauhawar hyperglycemia, glycosuria, gwargwadon lafiyar mai haƙuri.

Biosulin P shine mafi yawancin lokuta ana gudanar da shi a ƙarƙashin ƙasa, ba sau da yawa - intramuscularly. Yawan sha da lokacin ci gaban sakamako ya dogara ba kawai akan hanyar gudanar da mulki ba, har ma a wurin, adadi da maida hankali ga insulin.

Formaddamar da tsari da abun da ke ciki

Biosulin P yana samuwa azaman mafita don allura tare da sashi na 100 U / 1 ml. Kwalba na iya ƙunsar 5 ml ko 10 ml, 1, 2, 3 ko 5 a kowane fakitin. Wanda ya kirkiro maganin shine Marvel LifeSciences (India).

Ya hada da:

• insulin abinci mai narkewa - 100 MG,
• daban-daban magabata.

Magungunan yana cikin rukunin insulins da aka yi amfani da su don sauyawa magani, ana samar da shi ta hanyar injiniyan kwayoyin, kuma yana da takardar sayan magani.

Abun ciki da nau'i na saki

a cikin 10 ml vials, a cikin fakitin kwali 1 kwalba ko a cikin kwandon kwalliya na 3 ml, a cikin ɗayan kumbuyu mai ɗauri 5 inji, a cikin fakitin kwali 1 fakiti.

Alamu don amfani

• insulin-da ke fama da ciwon sukari mellitus (nau'in I),
• nau'in-insulin-dogara da ciwon sukari mellitus (nau'in II) tare da haɓakar juriya ga magungunan ƙwayoyin cuta na baka,
• nau'in-insulin-dogara da ciwon sukari mellitus (nau'in II) tare da haɓakar juriya na magungunan baka na maganin ƙwaƙwalwar ƙwayar cuta lokacin da suke ba da magani hade,
• daga cikin cututtukan zuciya (cututtukan m da ke kawo cikas ga ciwon sukari na kowane irin),
• lalata kwayar metabolism, wanda shine dalilin gaggawa a cikin mutane masu ciwon sukari.

Bugu da kari, kamar yadda likita ya umarta, ana iya amfani da insulins a cikin irin waɗannan halaye:

• a cikin shiri don hanyoyin tiyata a cikin marasa lafiya da masu fama da cutar siga na II,
• tare da ciwon sukari a cikin mata masu juna biyu,
• azaman magungunan anabolic a cikin gajiya mai wahala,
• tare da furunlera,
• tare da hyperthyroidism,
• da atoni ko ptosis na ciki,
• a cikin siffofin na kullum hepatitis,
• tare da cirrhosis na hanta a farkon cutar,
• a cikin yanayin cutar tarin yawa,
• a zaman wani bangare na lura da ciwon zuciya mai rauni.

Contraindications

Biosulin P an saba dashi:

• tare da kara karfin hankali game da kayan aiki ko wasu abubuwan maganin,
• tare da yanayin hypoglycemic na kowane asali,
• a cikin m hepatic, pancreatic, na koda cututtuka,
• tare da peptic ulcer na gastrointestinal fili,
• da lahanin zuciya a cikin matakin lalata,
• tare da bugun zuciya.

Hanyar aikace-aikace

Ana gudanar da maganin na minti 30 kafin cin abinci. An zabi sashi ne ta likitan daban.

Matsakaicin matsakaici kowace rana shine daga 0.5 zuwa 1 IU a kilo kilogram na nauyin haƙuri.

Lokacin amfani da Biosulin P azaman magani guda, ana gudanar dashi sau 3 / rana ko kuma ya karu zuwa 5-6 sau idan ya cancanta. A cikin adadin da ya wuce 0.6 IU / kg kowace rana, dole ne a yi amfani dashi a wurare daban-daban a cikin nau'i na 2 ko fiye da injections.

Mafi yawan wuraren allurar Biosulin P shine bangon ciki, amma ana iya amfani dashi a cikin gindi, cinya, da kafadu. Don hana haɓakar dystrophy na adipose nama a wurin allurar, dole ne a canza wurin allurar.

Ana aiwatar da aikin kulawa da jijiyoyin ciki da kulawa kawai a karkashin kulawar likita.

Gabatarwar kamar haka:

• yatsunsu biyu suna buɗe fata,
• an saka allura a cikin gindinta a wani kusurwa na digiri 45,
• subcutaneously drive kuma don cikakken gudanarwa, riƙe allura na daƙiƙiƙi kaɗan ƙarƙashin fatar, sannan cire.

Idan jini ya fito a allurar, danna shi da yatsa ka riƙe shi.

Side effects

• hypoglycemia, wanda aka bayyana ta hanyar pallor, gumi mai yawa, tachycardia, rawar jiki, abubuwan motsa jiki, yunwar. Asedara yawan jini a jiki yana haifar da cutar mahaifa.
• redness, itching da kumburi a wurin allurar,
• adipose nama dystrophy lokacinda ake sarrafa shi a wuri guda,
• tashin hankalin rashin jin daɗi yayin rashes, edema Quincke, anaphylaxis yana da wuya ake iya faɗi,
• kumburi ko raunin gani a matakin farko na maganin.

Abubuwan da suka haifar da ci gaban yanayin rashin lafiyar na iya zama:

• yawan abin sama da ya kamata na wani abu
• maye gurbin magani
• karancin abinci bayan sarrafa magunguna,
• amai, gudawa,
• activityara aiki a jiki,
• cututtuka waɗanda akwai raguwa a cikin buƙatun jiki don hormone, irin su ilimin cututtukan hanta ko ƙodan, raguwa a cikin aikin aiki na glandar adrenal, pituitary ko glandar thyroid,
• hulɗa tare da wasu kwayoyi.

Umarni na musamman

• lokacin da launi na mafita canza, bayyanar turbidity ko barbashi, ƙarin amfani yana contraindicated,
• A yayin yin jiyya tare da shirye-shiryen insulin, ya zama dole don kulawa da yawan adadin glucose a cikin jini,
• tare da dogon hutu tsakanin gabatarwa ko aikace-aikacen ƙwayar cuta mara kyau, haɓakar hyperglycemia mai yiwuwa ne, wanda ke bayyane ta hanyar jin ƙishirwa, yawan urination, tashin zuciya da amai, bayyanar jan launi da bushewar fata, raguwar ci da ƙanshi na acetone daga haƙuri. Idan babu magani don wannan yanayin, yana yiwuwa a haɓaka ketoacidosis, wanda ke barazanar rayuwa,
• tare da ƙara yawan aiki na jiki, kamuwa da cuta, zazzabi, cututtukan cututtukan ƙwayar thyroid, hanta, kodan da sauran cututtukan, har ma da shekaru 65 da canjin abinci, dole ne a daidaita sashin maganin,
• wasu cututtuka na iya ƙara buƙatar insulin (alal misali, cututtuka daban-daban tare da zazzabi),
• lokacin sauya magani, dole ne a kula da yawan glucose na jini,
• Biosulin P yana rage yawan shan giya,
• ba da shawarar yin amfani da famfo na insulin saboda yiwuwar ƙwayar ƙwayar cuta a cikin catheters.
• Tare da canje-canje daban-daban da ke hade da ilimin insulin, raguwa a cikin kwarewar tuki ko aikin aikin da ke buƙatar ƙara kulawa.

Hulɗa da ƙwayoyi

• isara yawan rage ƙwayar sukari na Biosulin P an lura lokacin ɗaukar: allunan magunguna masu rage sukari, wasu magungunan rigakafi, ragewar lipid, antihypertensive da diuretic, bromocriptine, octreotide, sulfanilamide da maganin rigakafin ƙwayoyin cuta, magungunan anabolic steroid, ketoconofolamine, cyclofenolamine, cyclofenolamine, cyclofenolamine, Tushen lithium, kwayoyi masu dauke da barasa.
• raguwa a cikin tasirin hypoglycemic yana faruwa lokacin ɗaukar rigakafin hormonal, glucocorticosteroids, hormones thyroid, wasu diuretics da antidepressants, heparin, magungunan juyayi, danazole, clonidine, magungunan antihypertensive, diazoxide, narcotic analgesics, nicotine.
• Reserpine na iya raunanawa da haɓaka aikin Biosulin R.

Analogues na Biosulin P sune insulins-gajere na aiki da kwayoyi kwatankwacinsu:

• Akwai NM na Actrapid a cikin 10 mil vials. Mai gabatarwa: Novo Nordisk (Denmark). Actrapid NM Penfill daga wannan masana'anta yana samuwa a cikin kwantena 3 ml na penfill. Akwai katako guda 5 a kowace fakiti,
• Vosulim-R shima yana zuwa ta hanyar katako da katako, masana'antar Wockhardt Limited (India),
• Gensulin R na masana'antar cikin gida, kamfanin masana'antu: Bioton Vostok ZAO (Russia),
• Insuman Rapid GT, Kamfanin Aventis Pharma Deutschland GmbH (Jamus),
• Insuran R ya samar da Cibiyar Nazarin Kwayoyin Kwayoyin cuta ta Bioorganic. Masana ilimi M.M.Shemyakin da Yu.A. Ovchinnikov RAS (Russia),
• Monoinsulin CR, Belmedpreparaty RUE (Jumhuriyar Belarus),
• Rinsulin R, GEROFARM-Bio OJSC (Russia),
• Rosinsulin R, Shuka ta Medsintez (Russia),
• Humulin Regular, Lilly Faransa (Faransa).

Pharmacodynamics

Fitsarin ɗan adam ne da aka samu ta amfani da fasahar DNA.

Yana hulɗa tare da takamaiman mai karɓa a kan ƙwayar cytoplasmic na sel na jikin mutum kuma yana samar da hadaddun insulin-receptor wanda ke motsa ayyukan cikin ciki, gami da kira na enzymes masu yawa (hexokinase, pyruvate kinase, glycogen synthetase). Raguwar glucose a cikin jini yana faruwa ne saboda karuwa a cikin jijiyoyin zuciya, karɓar karɓar ƙwaƙwalwa da ƙimar kyallen takarda, haɓakar lipogenesis, glycogenogenesis, da raguwa a cikin yawan samar da glucose ta hanta.

Tsawon lokacin aiwatar da shirye-shiryen insulin shine mafi yawanci saboda yawan sha, wanda ya dogara da abubuwa da yawa (alal misali, kashi, hanyar da wurin gudanarwar), sabili da haka bayanin aikin insulin yana haifar da canji mai mahimmanci, duka mutane daban-daban kuma a mutum guda. .

Bayan sc gwamnati, an lura da farawa na miyagun ƙwayoyi bayan kimanin mintuna 30, matsakaicin sakamako yana cikin tazara tsakanin 2 da 4 hours, tsawon lokacin aikin shine awoyi 6-8

Pharmacokinetics

Cikakken kamfani da kuma farawar insulin ya dogara da hanyar gudanarwa (sc ko intramuscularly) da kuma wurin gudanarwa (ciki, cinya, gindi), kashi (girman insulin allurar), da maida hankali kan insulin a cikin shiri.

An rarraba shi ba tare da daidaituwa ba a cikin kyallen takarda. Bai ƙetare katangar ƙwarya ba kuma ba a keɓance shi da madara ba.

An lalata shi ta hanyar insulinase galibi a cikin hanta da kodan.

T_1/2 - 'yan mintoci kaɗan. Cire cikin fitsari - 30-80%.

Alamun magungunan Biosulin ® R

type 1 ciwon sukari mellitus (insulin-dogara),

nau'in ciwon sukari na 2 na ciwon sukari (wanda ba shi da insulin-insulin ba): mataki na tsayayya da wakilai na bakin jini, juriya ga wadannan kwayoyi (yayin hada maganin), cututtukan da ke addabar mutane,

yanayin gaggawa a cikin marasa lafiya da ciwon sukari mellitus, tare da decompensation na carbohydrate metabolism.

Haɗa kai

Akwai kwayoyi da yawa waɗanda ke shafar buƙatar insulin.

Hypoglycemic sakamako na insulin inganta baka hypoglycemic kwayoyi, Mao hanawa, ACE hanawa, carbonic anhydrase hanawa, zabe beta-blockers, bromocriptine, octreotide, sulfonamides, anabolic steroids, tetracyclines, clofibrate, ketoconazole, mebendazole, pyridoxine, cyclophosphamide, fenfluramine, lithium, kwayoyi, dauke da sinadarin ethanol.

Maganin hana haihuwa, corticosteroids, hormones thyroid, thiazide diuretics, heparin, tricyclic antidepressants, sympathomimetics, danazole, clonidine, BKK, diazoxide, morphine, phenytoin, nicotine sun raunana tasirin maganin insulin.

Underarfafawar tasirin reserpine da salicylates, duka raunana da haɓaka a cikin aikin miyagun ƙwayoyi yana yiwuwa.

Yawan damuwa

Kwayar cutar hypoglycemia na iya haɓaka.

Jiyya: mai haƙuri na iya kawar da ɗimbin ƙwayar cuta mai narkewa ta hanyar shan sukari ko abinci mai-carbohydrate. Sabili da haka, ana ba da shawarar ga marasa lafiya da masu ciwon sukari don ɗaukar sukari, ruwan 'ya'yan itace mai zaki ko wasu Sweets tare da su.

A cikin lokuta masu tsauri, lokacin da mara lafiya ya rasa hankali, ana gudanar da maganin 40% na dextrose iv, i / m, s / c, iv glucagon. Bayan ya dawo da hankali, ana ba da shawarar mai haƙuri ya ci abinci mai arzikin carbohydrate don hana sake haɓakar ƙwanƙwasa jini.

Saki siffofin da abun da ke ciki

An gabatar da maganin allurar kamar ruwa mai launi mara launi. A matsayin ƙwayar aiki, 1 ml na dakatarwar ya ƙunshi IU 100 na inulin da aka ƙera ɗan adam. Don tsara pH na ruwa da kuma haɓaka bioavailability, ana amfani da kayan aiki mai aiki tare da abubuwan da aka haɗa:

• metacresol
• bakararre ruwa
• 10% maganin soda na caustic,
• maganin maganin hydrochloric acid na maida hankali ne 10%.

Ana iya samar da biosulin a cikin kwalabe gilashi ko katako tare da ƙaramin 3 ml, waɗanda aka tsara don amfani dasu tare da sirinji na Biomatic Pen. Kunshin kwali ya ƙunshi kwantena 5 a marufi firinji.

Aikin magunguna

Insulin yana biye da tsarin kwayar halittar jikin mutum ta hanyar sake hadewar DNA. Tasirin hypoglycemic shine saboda ɗaure abu mai aiki ga masu karɓa a farfajiyar kwayar sel. Godiya ga wannan fili, an samar da hadaddun sel tare da insulin, wanda ke haɓaka aikin enzymatic na hexose-6-phosphotransferase, glycogen synthesis da gushewar glucose. A sakamakon haka, ana lura da raguwa a cikin ƙwayar glucose jini.

Biosulin P yana haɓaka samuwar glycogen da mai mai daga glucose, yana rage jinkirin aiwatar da gluconeogenesis a cikin hanta.

Ana samun sakamako na warkewa ta hanyar haɓaka yawan sukari ta tsokoki. An inganta zirga-zirgarsa a cikin sel. Samuwar glycogen da kitse mai narkewa daga glucose yana ƙaruwa, kuma aiwatar da gluconeogenesis a cikin hanta yana sauka a hankali.

Lokacin lissafin tasirin hypoglycemic yana lissafin gwargwado, wanda, bi da bi, ya dogara da wuri da hanyar gudanar da insulin, halayen mutum na masu ciwon sukari. Bayan aikin ƙarƙashin ƙasa, ana lura da tasirin warkewa bayan rabin sa'a kuma ya kai matsakaicin ƙarfi tsakanin 3 zuwa 4 bayan amfani da katun. Tasirin hypoglycemic yana ɗaukar awanni 6-8.

Bioavailability da farkon aikin warkewa sun dogara da waɗannan abubuwan:

• hanyar aikace-aikacen - an yarda da allurar subcutaneous ko allurar intramuscular,
• yawan hodar iblis da aka gabatar
• wurin allura (dubura ciki, cinya na gaban kafa, gluteus maximus),
• insulin taro.

An rarraba kwayoyin halitta cikin tsari ba tare da daidaituwa ba a cikin jiki. An lalata aiki mai aiki a cikin hepatocytes da kodan. Rabin rayuwar shine minti 5-10. Abubuwan da ke aiki suna barin jiki a 30-80% tare da fitsari.

Insulin yana da ɗan gajeren sakamako.

Ana lissafin tsawon lokacin sakamako hypoglycemic bisa la'akari da ƙimar kimantawa.

Yadda ake ɗaukar Biosulin P

Yawan kwararrun likitoci suna yin amfani da su ne gwargwadon aikin mutum, gwargwadon alamun sukari na jini. An yarda da sarrafa kwayar halitta ta biosulin a cikin yanki, tare da wurare masu zurfi na tsokoki da cikin jijiyoyin ciki. Matsakaicin da aka ba da shawarar yawan amfanin yau da kullun ga manya shine 0.5-1 IU a kowace 1 kilogram na nauyi (kimanin raka'a 30-40).

Masana ilimin likita suna ba da shawara ga gudanar da maganin 30 mintuna kafin a fara cin abinci mai ɗauke da ƙwayoyi. A wannan yanayin, yawan zafin jiki na magungunan da aka gudanar ya kamata yayi daidai da zafin jiki na yanayi. Tare da monotherapy na biosulin, ana gudanar da wakili na hypoglycemic sau 3 a rana, a gaban abubuwan ciye-ciye tsakanin abinci, yawan injections yana ƙaruwa sau 5-6 a rana. Idan sashi ya wuce 0.6 IU a 1 kg na nauyin jiki, ya zama dole a sanya allura guda 2 a sassa daban daban na jikin ba a yanki daya na jikin mutum ba.

Wajibi ne a yi amfani da magani a karkashin fata a saman tsokoki na ciki, tare da dabarun aiwatar da ayyukan:

1. A wurin gabatarwar da aka gabatar, kuna buƙatar tattara fata a cikin crease ta amfani da babban yatsa da goshin hannu. Dole a saka allurar sirinji a cikin ninka fata a wani kusurwar 45 ° kuma piston ya yi ƙasa.
2. Bayan gabatarwar insulin, kuna buƙatar barin allura a ƙarƙashin fata na tsawon 6 ko sama da haka don tabbatar da cikakken gudanarwar maganin.
3. Bayan cire allura, jini na iya fitowa a wurin allurar. Yankin da abin ya shafa yakamata a matse tare da yatsa ko auduga ulu da aka sanyaya da barasa.

Haka kuma, kowane allurar dole ne a aiwatar da shi tsakanin iyakokin yankin ilimin halittar jiki, canza wurin allurar. Wannan ya zama dole don rage yiwuwar lipodystrophy. Maganin ciki da allura na cikin jijiya ne kawai ke gudana daga kwararrun likitoci. An haɗa insulin gajere da wani nau'in insulin tare da sakamako mai warkewa.

Tare da monotherapy tare da Biosulin, ana gudanar da wakili na hypoglycemic wakili sau 3 a rana.

Amfani da barasa

Ethyl barasa ya cutar da tsarin jijiyoyin jini da kuma aikin hanta da kodan. A sakamakon haka, narkewar metabolism, wanda zai haifar da asarar sarrafa glycemic. Yiwuwar samun hauhawar jini ya ƙaru. Saboda haka, a lokacin yin magani tare da miyagun ƙwayoyi, an haramta shan giya.

Ana iya maye gurbin miyagun ƙwayoyi ta nau'ikan insulin masu aiki da sauri:

• Insuman Rapid GT,
• NM Penfill,
• Gensulin P,
• Humulin akai-akai.

Ra'ayoyi game da Biosulin P

Magungunan sun kafa kanta a cikin kasuwar magunguna saboda kyakkyawan sakamako daga likitoci da marasa lafiya.

Elena Kabluchkova, endocrinologist, Nizhny Novgorod

Ingantaccen magani na insulin wanda ke taimakawa tare da hyperglycemia na gaggawa a cikin masu ciwon sukari. Alƙalin sirinji ya dace wa marasa lafiya da jigilar jigilar rayuwa da aiki. Wani ɗan gajeren aiki yana taimaka wajan hanzarta magance babban sukari. Godiya ga saurin nasarar tasirin warkewa, zaku iya amfani da katun kafin cin abinci. An yarda da amfani da kwayoyin halitta don amfani dashi tare da wasu magunguna dangane da insulin aiki na tsawon lokaci. Marasa lafiya na iya karɓar magani a ragi.

Olga Atamanchenko, endocrinologist, Yaroslavl

A cikin aikin asibiti, Ina kan tsara magunguna tun Maris 2015. Tare da shigowar wannan nau'in insulin a cikin masu ciwon sukari, ingancin rayuwa yana inganta, da yiwuwar hauhawar jini da hauhawar jini. An ba da izinin amfani dashi a cikin yara da mata masu juna biyu. Godiya ga insulin gajere, mai haƙuri na iya gudanar da maganin a cikin yanayin gaggawa (tare da matakan sukari). Ina ɗaukar Biosulin a matsayin magani mai sauri, ingantaccen magani.

Stanislav Kornilov, mai shekara 53, Lipetsk

Ingantaccen gajeran aiki insulin. Na yi amfani da Gensulin da Farmasulin, amma zan iya samun kyakkyawan raguwa a cikin taro na glucose kawai godiya ga Biosulin. Magungunan ya tabbatar da kansa a hade tare da Insuman Bazal - insulin na dogon lokaci. Godiya ga saurin sakamako, Na sami damar faɗaɗa abincin 'ya'yan itatuwa. Na lura cewa daga magunguna na baya kaina sau da yawa yana ciwo, amma ba a lura da wannan sakamako ba. Na gamsu da sakamakon, amma babban abin shine bin umarni don amfani da abincin da aka tsara.

Oksana Rozhkova, mai shekara 37, Vladivostok

Shekaru 5 da suka gabata, tana cikin kulawa mai zurfi dangane da lalata yanayin ciwon sukari, wanda ba ta sani ba. Bayan ya isa ga sarrafa glycemic, likita yayi magana game da ganewar asali kuma ya wajabta Biosulin akan ci gaba mai gudana. Ya ce ya fi dacewa a yi amfani da maɓallin sirinji. Yayin da aka yi maganin, maganin sukari ya kasance a cikin iyaka. Amma wannan nau'in insulin gajere ne, kuma ya wajaba a zabi wani nau'in tare da sakamako mai tsayi. Na ji tsoron cewa magungunan ba za su dace ba, amma ba a tabbatar da shakku ba. Yana da kyau don haɗuwa da wani nau'in insulin.