Insuman - instructions for use, analogs, reviews and formulation (suspension for injection Basal 100 IU / ml and Combe 15 HT 25 HT and 50 HT Rapid 100 IU / ml solution) preparation for the treatment of diabetes mellitus in adults, children and pregnancy. Composition

In this article, you can read the instructions for using the drug Insuman. Comments of visitors of the site - consumers of this medication, as well as opinions of specialists on the use of Insuman in their practice are presented. A big request is to actively add their feedback on the drug: the medicine helped or did not help get rid of the disease, which were observed complications and side effects, possibly not declared by the manufacturer in the annotation. Analogues of Insuman with available structural analogues. Use for the treatment of diabetes in adults, children, as well as during pregnancy and lactation.Composition and interaction of the drug with alcohol.

 

Insuman - a hypoglycemic preparation, contains insulin, identical in structure to human insulin, obtained by genetic engineering using E. coli. Insulin reduces the concentration of glucose in the blood, promotes anabolic effects and reduces catabolic effects. Increases the transport of glucose into cells and the synthesis of glycogen in muscles and liver, improves the utilization of pyruvate, inhibits glycogenolysis and gluconeogenesis. Insulin increases lipogenesis in the liver and adipose tissue and inhibits lipolysis. Promotes the intake of amino acids in cells and the synthesis of protein, increases the flow of potassium into the cells.

 

Insuman Bazal HT is a long-acting insulin with a gradual onset of action. Insuman Rapid HT is insulin with a rapid onset and a short duration of action. Insuman Comb is insulin with a quick-acting effect and an average duration of action.

 

Composition

 

Crystalline protamine of insulin + auxiliary substances (Insuman Bazal GT).

 

Insulin soluble + excipients (Insuman Rapid GT).

 

Neutral insulin solution 15 IU + Crystal protamine of insulin 85 IU + auxiliary substances (Insuman Comb 15 GT).

 

Neutral insulin solution 25 IU + Crystalline insulin protamine 75 IU + excipients (Insuman Comb 25 GT).

 

Neutral insulin solution 50 IU + Crystal protamine insulin 50 IU + excipients (Insuman Combo 50 GT).

 

Pharmacokinetics

 

The effect of Insuman Bazal HT after subcutaneous injection occurs within 1 hour, reaches a maximum after 3-4 hours, persists for 11-20 hours.

 

The effect of insuman Rapid HT after subcutaneous injection occurs within 30 minutes, reaches a maximum after 1-4 hours, persists for 7-9 hours.

 

Insuman Comb 15 GT is characterized by a rapid onset (after 30-45 minutes) and an average duration (11-20 hours) of action, Insuman Comb 25 GT, respectively, 30-60 minutes and 12-19 hours, Insuman Combe 50 GT - 30 minutes ( with a maximum effect after 1-1.5 hours) and 10-16 hours, respectively.

 

Indications

• insulin-dependent diabetes mellitus (type 1 diabetes mellitus);
• insulin-independent diabetes mellitus (type 2 diabetes mellitus), including with complete or partial resistance to oral hypoglycemic agents, with intercurrent diseases,inefficiency of diet therapy, surgical interventions, during pregnancy;
• treatment of diabetic coma and ketoacidosis.

 

Forms of release

 

Suspension for subcutaneous administration in 3 ml cartridges, 3 ml syringe pens or 5 ml vial (Insuman Bazal GT).

 

Solution for injection in cartridges 3 ml, syringe-pens 3 ml or in a vial 5 ml (Insuman Rapid GT).

 

Suspension for injection in vial 5 and 10 ml (Insuman Comb 15 GT).

 

Suspension for injection in a 5 ml vial or 3 ml cartridges (Insuman Komb 25 Gt, Insuman Komb 50 Gt).

 

Instructions for use and dosing regimen

The target blood glucose concentration, insulin preparations that should be used, the insulin dosage regimen (doses and timing of administration) should be determined and adjusted individually, so that they correspond to the diet, the level of physical activity and the lifestyle of the patient.

 

There are no strictly regulated dosing rules for insulin. However, the average daily dose of insulin is 0.5-1 ME per 1 kg of body weight per day, and the share of human insulin prolonged action accounts for 40-60% of the required daily dose of insulin.

 

The patient should be given the necessary instructions on the frequency of determining the concentration of glucose in the blood,and also appropriate recommendations in case of any changes in the diet or in the mode of insulin therapy.

 

Switching from another type of insulin to Insuman

 

When transferring patients from one type of insulin to another, it may be necessary to adjust the dosage regimen of insulin: for example, when switching from animal insulin to human insulin, from one preparation of human insulin to another, or from a regime of treatment with soluble human insulin to a regime that includes insulin longer lasting.

 

After switching from animal insulin to human insulin, a reduction in the insulin dose may be required, especially in patients who had previously been administered at low enough blood glucose levels; in patients with a tendency to develop hypoglycemia; in patients who previously required high doses of insulin due to the presence of antibodies to insulin.

 

The need for correction (reduction) of the dose can occur immediately after switching to a new type of insulin or develop gradually over several weeks. When switching from one type of insulin to another and then in the first weeks, careful monitoring of the concentration of glucose in the blood is recommended.Patients who required high doses of insulin because of the presence of antibodies, it is recommended to switch to another type of insulin under medical supervision in the hospital.

 

Additional dose adjustment

 

Improved metabolic control can lead to an increase in insulin sensitivity, which may reduce the body's need for insulin. Dose changes may also be required when the patient's body weight changes, lifestyle changes (including diet, physical activity level), other circumstances that may increase the predisposition to hypo- or hyperglycemia. In patients with hepatic or renal insufficiency, the need for insulin may decrease.

 

Introduction of Insuman

 

Insuman Bazal HT is usually injected deeply subcutaneously 45 to 60 minutes before a meal. Insuman Rapid HT is usually injected deeply subcutaneously 15-20 minutes before meals. Insuman Comb 15 GT and Insuman Komb 25 GT are usually administered subcutaneously 30-45 minutes before taking the food. Insuman Comb 50 GT is usually administered subcutaneously 20-30 minutes before the intake of food.

 

Place the injection within the same injection area each time should be changed.Change the area of ​​insulin administration (for example, from the abdomen to the thigh area) should be done only after consultation with the doctor, as this affects its absorption. Insuman should not be used in various kinds of insulin pumps (including implanted ones). Intravenous introduction Insuman Bazal GT and Insuman Comb HT are absolutely excluded! Insuman Rapid HT can be administered intravenously in a hospital setting or under conditions in which similar monitoring and treatment conditions can be provided.

 

It should be remembered that the concentration of insulin is 100 IU / ml (for 5 ml bottles or 3 ml cartridges), therefore it is necessary to use only plastic syringes calculated for this concentration of insulin in case of using bottles, or with Optiphen Pro 1 or use of cartridges. A plastic syringe should not contain any other drug or its residual quantities.

 

Terms of use Insuman in vials

 

Before the first set of insulin from the vial, it is necessary to remove the plastic cap (the presence of a cap is evidence of an unopened vial).Immediately before the set, the suspension should be well mixed, holding the bottle at an acute angle between the palms and gently turning it (without the formation of foam).

 

Before dialing insulin from the vial into the syringe, you should collect an air volume equal to the prescribed dose of insulin and enter it into the vial (not into the liquid). Then the vial with the syringe must be turned with a syringe down and dialed the necessary amount of insulin. Before injection, it is necessary to remove air bubbles from the syringe. At the injection site, you must collect a skin fold, insert the needle under the skin and slowly inject insulin. After injection, the needle should be slowly removed and the cotton swab pressed to the injection site for a few seconds. The date of the first set of insulin from the vial should be written on the label of the vial.

 

After opening, the vials should be stored at a temperature of no higher than 25 degrees for 4 weeks in a place protected from light and heat.

 

Terms of Use Insuman in cartridges

 

Before installing the cartridge (100 IU / ml) into the Optiphen Pro 1 and the ClickSTART syringe, you should hold it for 1-2 hours at room temperature (chilled insulin injections are more painful).After this, softly turning the cartridge (up to 10 times), it is necessary to obtain a homogeneous suspension. Each cartridge additionally has three metal balls for faster mixing of its contents. After installing the cartridge in the syringe pen, before each injection of insulin, several times turn the syringe handle to obtain a homogeneous suspension. It is necessary to remove any air bubbles from the cartridge before injection.

 

The cartridge is not designed to mix Insuman with other insulins. Empty cartridges can not be refilled. In the event that the syringe pen has failed, you can enter the required dose from the cartridge using a conventional syringe. After installing the cartridge, it should be used within 4 weeks. It is recommended to store cartridges at a temperature of no higher than 25 degrees in a place protected from light and heat. During the use of the cartridge, the syringe pen should not be stored in the refrigerator. After installing a new cartridge, you should check the correct operation of the syringe pen prior to the injection of the first dose.

 

Rules for the use and handling of a pre-filled SoloStar pen

 

Insuman injection for single-use syringe-handle SoloStar, including Insuman Rapid GT, is intended only for subcutaneous administration. Before the first use, the syringe pen should be held at room temperature for 1-2 hours. Before use, inspect the cartridge inside the pen syringe after thoroughly mixing the suspension in it by rotating the syringe pen around its axis, keeping it at an acute angle between the palms. The syringe pen should be used only if, after mixing, the suspension has a uniform consistency and milky-white color (Insuman Bazal GT and Insuman Comb HT), and for Insuman Rapid, the solution should be clear. Empty SoloStar pens should not be reused, they must be destroyed. To prevent infection, a pre-filled syringe pen should be used by only one patient, it should not be transferred to another person.

 

Information on the use of the syringe handle SoloStar

 

Before each use, you must carefully attach a new needle to the syringe pen and conduct a safety test.It is necessary to use only those needles that are compatible with SoloStar. It is necessary to take special precautions to avoid accidents involving the use of the needle and the possibility of transfer of infection. Do not use the SoloStar pen when it is damaged or if it is not certain that it will work properly. It is always necessary to have a spare SoloStar pen in case there is a loss or damage to the main specimen of the syringe pen.

 

Storing the syringe pen

 

If the SoloStar pen is stored in the refrigerator, it must be removed 1-2 hours before the proposed injection so that the suspension reaches room temperature. The introduction of chilled insulin is more painful. The used SoloStar pen should be destroyed.

 

Exploitation

 

The syringe handle SoloStar must be protected from dust and dirt. The outer side of the SoloStar syringe can be cleaned by wiping it with a damp cloth. Do not immerse in liquid, rinse and lubricate the SoloStar syringe, as this can damage it.

 

The syringe-pen SoloStar precisely doses the insulin and is safe in work.But it requires careful handling: avoid situations in which damage can occur. If you suspect a damage, use a new syringe pen.

 

1. Insulin control

 

It is necessary to check the label on the SoloStar pen to make sure that it contains the appropriate insulin. For the preparation Insuman Bazal GT a syringe pen SoloStar is white with a green button for injection. After removing the cap of the syringe-pen, you need to check the appearance of the insulin contained in it: the suspension after mixing should have a uniform consistency and milky-white color.

 

For the preparation Insuman Rapid GT, a white-colored SoloStar pen with a yellow button for injection with a relief ring on it. After removing the cap of the syringe-pen, it is necessary to check the appearance of the insulin contained in it: the solution must be absolutely transparent, colorless, without visible foreign particles.

 

The Syringe handle SoloStar with Insuman Coomb has a white color, and the injection button is colored. The color of the start button differs depending on the type of Insuman drug that is applied.After mixing, the liquid must be uniform and have a milky color.

 

2. Attaching the needle

 

It is necessary to use only those needles that are compatible with the syringe handle SoloStar. For each subsequent injection, a new sterile needle should be used. After removing the cap, the needle should be carefully installed on the syringe pen.

 

3. Performance of the safety test

 

Before each injection, a safety test must be carried out to ensure that the syringe pen and needle work well and air bubbles are removed. You should measure a dose equal to 2 units. The outer and inner caps must be removed. When placing the needle with the needle up, gently tap with the finger on the cartridge with insulin in such a way that all air bubbles go to the needle. It is necessary to press the injection injection button completely. If insulin appears at the tip of the needle, it means that the pen and needle work correctly. If the appearance of insulin at the tip of the needle is not observed, then step 3 should be repeated until the insulin appears on the tip of the needle.

 

4. Dose selection

 

The dose can be set to an accuracy of 1 unit from the minimum dose (1 unit) to the maximum dose (80 units).If more than 80 units are needed, two or more injections should be given.

The dosage window should indicate "0" after the completion of the safety test. After this, the required dose can be set.

 

5. Dosing Introduction

 

The needle must be inserted under the skin. The injection button should be pressed completely. Until the needle is removed, the button should be held in this position for 10 seconds. Thus, the introduction of a selected dose of insulin is ensured completely.

 

6. Extracting and destroying the needle

 

In all cases, the needle after each injection should be removed and discarded. This ensures the prevention of contamination and infection, the entry of air into the reservoir for insulin and the leakage of insulin.

 

When removing and destroying the needle, special precautions (for example, the technique of putting the cap on with one hand) should be followed in order to reduce the risk of accidents involving the use of the needle, and to prevent infection.

 

After removing the needle, close the SoloStar pen with the cap.

 

Side effect

• hypoglycemic conditions (pallor, increased sweating, palpitations, sleep disorders, tremor);
• hypoglycemic precoma and coma;
• skin rash;
• angioedema;
• hyperemia and itching at the injection site;
• lipodystrophy (change of adipose tissue) at the injection site with prolonged use.

 

Contraindications

• hypoglycemia (low blood glucose);
• insulinoma (a hormone-active pancreas tumor);
• increased sensitivity to this insulin.

 

Application in pregnancy and lactation

 

Treatment with the drug should be continued during pregnancy. Effective maintenance of metabolic control throughout pregnancy is mandatory for women who had diabetes mellitus before pregnancy, and women who developed gestational diabetes mellitus.

 

The need for insulin during pregnancy can decrease in the first trimester of pregnancy and usually rises in the second and third trimesters of pregnancy. Immediately after delivery, the need for insulin rapidly decreases (an increased risk of developing hypoglycemia). In pregnancy and especially after childbirth, careful monitoring of the concentration of glucose in the blood is mandatory. When planning pregnancy or the onset of pregnancy, you should always inform the doctor about it.

 

During breastfeeding, there is no restriction in treatment, but a diet or dose adjustment may be required. Insulin does not penetrate the placental barrier.

 

Use in children

 

Used as the main drug in children with a low need for insulin. In the case of development of hypoglycemia against the background of taking the drug, intravenous administration of a concentrated solution of Dextrose is recommended. In children, the amount of dextrose administered is proportional to the body weight of the child.

 

After increasing the concentration of glucose in the blood, it may be necessary to maintain carbohydrate intake and observation, since after the apparent clinical elimination of symptoms of hypoglycemia, its re-development is possible. In cases of severe or prolonged hypoglycemia, following the injection of glucagon or the administration of dextrose, it is recommended that infusion of less concentrated dextrose solution be used in order to prevent the re-development of hypoglycemia. In young children, the concentration of glucose in the blood should be carefully monitored in connection with the possible development of severe hyperglycemia.

 

Application in elderly patients

 

In elderly patients, the need for insulin can be reduced. Therefore, the initiation of treatment, increasing the dose and selecting a maintenance dose in elderly patients with diabetes should be done with caution in order to avoid hypoglycemic reactions.

 

special instructions

 

In case of insufficient glucose control or a tendency to the appearance of hyper- or hypoglycemia episodes before deciding whether the correction of insulin dose should be sure to verify that the prescribed regimen of insulin administration, to make sure that the insulin is injected into the recommended area, check the correctness of injection equipment and other factors, which can affect the effect of insulin. Since the simultaneous administration of a number of drugs can weaken or intensify the hypoglycemic effect of the Insuman drug, do not use other drugs without special permission from the doctor when using it.

 

Hypoglycaemia

 

Hypoglycemia occurs if the dose of insulin exceeds the need for it. The risk of hypoglycemia is high at the beginning of treatment with insulin, when another insulin preparation, patients with low maintenance concentration of glucose in the blood.

 

As with other insulins, special care should be taken and intensive monitoring of blood glucose in patients for whom hypoglycemic episodes can be of particular clinical importance, such as patients with severe stenosis of the coronary or cerebral arteries (risk of cardiac or cerebral complications of hypoglycemia) , as well as in patients with proliferative retinopathy, especially if they did not undergo photocoagulation (laser therapy), since they have a risk of transient amaurosis (full blindness) with the development of hypoglycemia.

 

There are certain clinical signs and symptoms that can indicate to the patient or others about developing hypoglycemia. These include: increased sweating, skin moisture, tachycardia, heart rhythm disturbances, increased blood pressure, chest pains, tremor, anxiety, hunger, drowsiness, sleep disorders, feelings of fear, depression, irritability, unusual behavior, paresthesia in the mouth and around the mouth, pallor of the skin, headache, movement coordination disorders, as well as transient neurological disorders (speech and vision disorders, paralytic symptoms) and unusual sensations.With an increasing decrease in glucose concentration, the patient may lose self-control and even consciousness. In such cases, coldness and moisture of the skin can be observed, and convulsions may also appear.

 

Each patient with diabetes who receives insulin should learn to recognize unusual symptoms that are signs of developing hypoglycemia. Patients regularly monitoring the concentration of glucose in the blood are less likely to develop hypoglycemia. The patient can adjust himself the observed decrease in blood glucose concentration by taking sugar or foods high in carbohydrates. For this purpose, the patient should always carry 20 g of glucose. In more severe hypoglycemic conditions, a subcutaneous injection of glucagon is indicated, which can be done by a doctor or nursing staff. After sufficient improvement, the patient should eat. If hypoglycemia can not be immediately remedied, then it is urgent to call a doctor. It is necessary to inform the doctor immediately about the development of hypoglycemia, so that he makes a decision about the need to correct the dose of insulin.

 

Failure to comply with diet, insulin injection, increased insulin requirements due to infectious or other diseases, decreased physical activity may lead to increased blood glucose (hyperglycemia), possibly with an increase in the concentration of ketone bodies in the blood (ketoacidosis). Ketoacidosis can develop within a few hours or days. At the first symptoms of metabolic acidosis (thirst, frequent urination, loss of appetite, fatigue, dry skin, deep and rapid breathing, high concentrations of acetone and glucose in the urine), urgent medical intervention is necessary. When a doctor changes (for example, when hospitalized for an accident, a sickness during a vacation), the patient should report that he has diabetes mellitus.

 

Patients should be warned about conditions that may change, be less pronounced, or completely absent symptoms warning of hypoglycemia, for example:

• with a significant improvement in glycemic control;
• with gradual development of hypoglycemia;
• in elderly patients;
• in patients with autonomic neuropathy;
• patients with a long history of diabetes mellitus;
• patients who are simultaneously receiving treatment with certain drugs.

 

Such situations can lead to the development of severe hypoglycemia (possibly with loss of consciousness) earlier than the patient realizes that he develops hypoglycemia.

 

In case of detection of normal or decreased values ​​of glycosylated hemoglobin, consideration should be given to the possibility of developing recurring, unrecognized (especially nocturnal) episodes of hypoglycemia. To reduce the risk of hypoglycemia, it is required that the patient accurately follow the prescribed dosing regimen and diet, properly administered insulin injections and be warned about the symptoms of developing hypoglycemia.

 

Factors that increase predisposition to the development of hypoglycemia require careful monitoring and may require dose adjustment. These factors include:

• change in the area of ​​insulin administration;
• increased sensitivity to insulin (eg, elimination of stress factors);
• unusual (increased or prolonged) physical activity;
• intercurrent pathology (vomiting, diarrhea);
• inadequate intake of food;
• skipping meals;
• alcohol consumption;
• Some uncompensated endocrine diseases (such as hypothyroidism and insufficiency of the anterior lobe of the pituitary gland or insufficiency of the adrenal cortex);
• simultaneous use of certain medicines.

 

Intercurrent diseases

 

Intercurrent diseases require intensive metabolic control. In many cases, the analysis of urine for the presence of ketone bodies is indicated. It often requires a correction of the insulin dose. The need for insulin is often increased. Patients with type 1 diabetes should continue to regularly consume at least a small amount of carbohydrates, even if they can take only a small amount of food or if they have vomiting. Patients should not completely stop the introduction of insulin.

 

Cross immunological reactions

 

In a fairly large number of patients with increased sensitivity to insulin of animal origin, it is difficult to switch to human insulin due to a cross-reactive immunological reaction to human insulin and animal insulin.If the patient is sensitive to insulin of animal origin, as well as to m-cresol, the tolerance of Insuman should be evaluated in the clinic using intradermal tests. If the intradermal test reveals an increased sensitivity to human insulin (immediate reaction, such as Arthus), then further treatment should be carried out under medical supervision.

 

Impact on the ability to drive vehicles and manage mechanisms

 

The patient's ability to concentrate and the speed of psychomotor reactions can be compromised by hypoglycemia or hyperglycemia, as well as by visual disorders. This can pose a certain risk in situations where these capabilities are important (driving or other mechanisms).

 

Patients should be careful and avoid hypoglycemia while driving. This is especially important in patients who have reduced or no awareness of symptoms indicating the development of hypoglycemia, or there are frequent episodes of hypoglycemia. Such patients should individually address the issue of the possibility of driving or other mechanisms.

 

Drug Interactions

 

The simultaneous use of oral hypoglycemic drugs, ACE inhibitors, disopyramide, fibrates, fluoxetine, MAO inhibitors, pentoxifylline, propoxyphenyl, salicylates, amphetamine, anabolic steroids and male sex hormones, tsibenzolinom, cyclophosphamide, fenfluramine, guanethidine, ifosfamide, phenoxybenzamine, phentolamine, somatostatin and its analogs, sulfonamides, tetracyclines, tritokvaline or trophosphamide may increase the hypoglycemic effect of insulin and increase pr draspolozhennost hypoglycemia.

 

Concurrent use with corticotropin, glucocorticosteroids, danazol, diazoxide, diuretics, glucagon, isoniazid, estrogens and progestins (eg, present in CPC), phenothiazine derivatives, somatotropin, sympathomimetic agents (eg epinephrine, salbutamol, terbutaline), thyroid hormones, barbiturates, nicotinic acid, phenolphthalein, phenytoin derivatives, Doxazosin can weaken the hypoglycemic action of insulin.

 

Beta-adrenoblockers, clonidine, lithium salts can either potentiate or weaken the hypoglycemic action of insulin. Alcohol can potentiate or weaken the hypoglycemic effect of insulin. Its use can cause hypoglycemia or reduce the already low blood glucose to a dangerous level. Tolerance of ethanol in patients receiving insulin is reduced. The doctor should determine the allowable amount of ethanol consumed.

 

With the simultaneous use of pentamidine, hypoglycemia may develop, which can sometimes translate into hyperglycemia. With simultaneous use with sympatholytic agents, such as beta-blockers, clonidine, guanethidine and reserpine, it is possible that the sympathetic nervous system may be weakened or completely absent from the reflex (in response to hypoglycemia) activation. Hypoglycemic effect of insulin is enhanced by MAO inhibitors, non-selective beta-blockers, sulfonamides, anabolic steroids, tetracyclines, clofibrate, cyclophosphamide, fenfluramine, preparations containing ethanol.

 

The hypoglycemic effect of insulin reduces oral contraceptives, glucocorticoids, thyroid hormones, thiazide diuretics,heparin, lithium preparations, tricyclic antidepressants. Under the influence of reserpine and salicylates, both weakening and enhancement of insulin action are possible. Beta-adrenoblockers, clonidine, reserpine can mask the manifestation of symptoms of hypoglycemia. Ethanol, various disinfectants can reduce the biological activity of insulin.

 

Analogs of the drug Insuman

 

Structural analogs for the active substance:

• Actrapid NM;
• Biosulin P;
• Biosulin 30/70;
• Vozulim P;
• Gensulin R;
• Insuran R;
• Mixtard NM Penfill;
• Monoinsulin CR;
• Monotard NM;
• Protamine insulin ES;
• Protafan NM;
• Rinsulin NPH;
• Rosinsulin;
• Ultradard NM;
• Homolong;
• Humodar R 100 RIV;
• Humulin Regular;
• Khumulin L;
• Humulin M2 20/80;
• Khumulin MZ.

 

Doctor's Feedback-endocrinologist

 

Insuman - quality insulin of German production with different duration of action. Patients with type 1 diabetes usually receive multiple injections of the drug during the day. Rapid insulin Rapid is administered subcutaneously before the main meals usually in the abdominal region. Insuman Bazal of average duration of action is administered at night and before breakfast in the area of ​​the hip or shoulder, from there it is more slowly and uniformly released.The daily dose varies from 0.6 to 1 IU per kilogram of weight, and depends on the level of physical activity and diet of the patient. On meals, it is distributed approximately like this: 40% before breakfast, and 30% before dinner and dinner. The main advantage of the drug is an affordable price on an equal basis with analogues and a convenient form of release in the form of cartridges and syringe pens, which greatly simplifies the diabetic dosing of the drug and the process of its administration.

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