DALILIN DA YASA ALLURAR INSULIN TA ASIBITI KAN IYA RASHIN AMFANI

Idan sukarin jinin mara lafiya a asibiti ya yi yawa, amsar da aka fi saba ita ce insulin na ma’aunin zamewa (sliding-scale insulin): ana auna sukari kowace ’yan awanni, kuma ma’aikaciyar jinya tana yin allurar insulin gwargwadon yadda karatun ya wuce wani buri. Jagororin yanzu sun riga sun hana amfani da shi shi kaɗai. Amma, marubutan sun nuna, shaidar ta fito ne kusan gaba ɗaya daga manya masu ciwon sukari na nau’i na 2, kuma lissafin da ke bayan allurar an tsara shi ne ga mutanen da jikinsu ba ya samar da insulin.

Marasa lafiya da yawa a asibiti ba su dace da wannan hoton ba: pancreas ɗinsu yana aiki, amma steroids ko abinci ta jijiya suna ɗaga sukarinsu. A gare su, allura ba ta aiki a kan jiki mara motsi. Tana aiki ne a kan tsarin da ya riga ya mallaki mai sarrafawa — pancreas, wanda ke rage abin da yake fitarwa a duk lokacin da sukari ya sauka.

Mara lafiya ɗaya, da aka karanta a matsayin tsarin sarrafawa

Nir da Guy Regev, na Regev Labs a California, suna kallon ma’aunin zamewa ta fuskar injiniyan sarrafawa (control engineering): mai sarrafawa mai daidaito (proportional controller) da ke ɗaukar samfuri kowace awa huɗu. Sun gina samfurin sukari da insulin a jiki, an daidaita shi bisa bayanan mara lafiya ɗaya: wata yarinya ’yar shekara 17 mai nauyin kilo 45, kwanaki 41 zuwa 51 bayan dashen ƙwayoyin halitta na tushe (stem cell transplant), ana ciyar da ita gaba ɗaya ta jijiya kuma ana ba ta methylprednisolone mai yawa, wani steroid. Ba ta da ciwon sukari a da. Takardar lafiyarta tana ɗauke da auna sukari 45 cikin kwanaki goma sha ɗaya. Daga nan suka gwada abubuwan da suka gano kan marasa lafiya na kwaikwayo 4,995 da aka samar daga kewayon ilimin jiki da aka wallafa.

Sun gano kasawa uku kuma sun ce babu ko ɗaya da za a iya gyara ta hanyar zaɓar wani ma’aunin allura dabam.

Pancreas yana soke sirinji

A cikin samfurin, madaukin sukarin jikin mara lafiyar yana natsuwa cikin mintuna 11.5, alhali insulin da aka yi allura yana ɗaukar minti 64 kafin ya kai ƙololuwa. Yayin da insulin da aka yi allura ya fara aiki, pancreas ɗinta kawai yana rage fitarwa. Unit ɗaya a kowace awa yana rage sukari da mg/dL 23, abin da ke rage fitarwar jikinta da unit 0.7 a kowace awa: kashi 70% na allurar ana maye gurbinsa maimakon a ƙara.

Idan aka yi kwaikwayon ƙa’idar kamar yadda aka rubuta ta na kwanaki tara, ta ba da ƙasa da unit ɗaya a rana kuma ta motsa matsakaicin sukarinta da ƙasa da mg/dL 1.5. Takardar lafiyarta ta nuna abu iri ɗaya: wani dare karatun mg/dL 173 ba a gyara shi ba, kuma sukari ya sauka da mg/dL 57 a cikin awanni 7.4 masu zuwa da kansa. A cikin dukkan marasa lafiyan kwaikwayo, pancreas ya samar da kashi 53% na gyaran a tsaka-tsaki (median), kuma ƙa’idar da aka rubuta ta yi rauni sosai har ba ta da tasiri a kowane mara lafiyan kwaikwayo.

Isasshen ƙarfi ya yi ƙarfi da yawa

Matsala ta biyu ita ce unit ɗaya na insulin ba koyaushe yake yin abu ɗaya ba. A cikin samfurin, yana rage sukari da mg/dL 11.6 a mg/dL 110, amma 5.8 kawai a 190. Don haka ma’aunin allura da ya isa ƙarfi don gyara babban karatu yana wuce gona da iri idan sukari ya kusa daidai; wanda ba ya taɓa wuce gona da iri ba ya yin komai a babban sukari. A cikin kashi 99.5% na marasa lafiyan kwaikwayo, babu ma’auni ɗaya da zai iya yin duka biyun. Girman giɓin ya bambanta: ninki biyu ga wannan mara lafiyar, kusan kashi 30% ga pancreas da ke aiki kamar tsibiran ƙwayoyin halittar mutum (islets) da aka auna a ɗakin bincike. Kamar yadda marubutan suka faɗa, ma’aunin da aka rubuta yana da aminci saboda ba ya yin komai.

Hagu: raguwar sukari da samfurin ya ƙiyasta a kowane unit na insulin, ƙasa da ma’aunin 40 da aka rubuta sosai. Tsakiya: sama da layin ɗigo-ɗigo, kowane gyara yana wuce burinsa. Dama: sukari da samfurin ya ƙiyasta bayan zuba wani magani da aka narkar a cikin dextrose na awa ɗaya. — Figure 1, Regev & Regev (2026), arXiv:2610.08730.

Awa huɗu sun yi jinkiri sosai

Ana ba da steroid ɗin sau biyu a rana, kuma aune-aunen suna nuna — a kan ƙananan bayanai — wani zagaye na awa 12 a cikin sukari. Auna kowace awa huɗu ta yi ƙaranci sosai don bin sa, don haka karatu a jere kusan ba su da alaƙa da juna: kowace allura tana amsa ƙimar da ta riga ta canza. Samfurin ya kuma nuna sukari da aka ɓoye: an narkar da N-acetylcysteine da maganin ƙwayoyin cuta levofloxacin a cikin dextrose kuma aka zuba su ta jijiya cikin awa ɗaya, suna ƙara hauhawar da samfurin ya ƙiyasta ta mg/dL 30 zuwa 47 da auna na yau da kullum kusan ba sa kamawa. Karatun da aka ɗauka a kan wannan hauhawar, haɗe da ma’aunin allura “mai tasiri”, zai iya saukar da sukari zuwa matakin haɗari a cikin samfurin. Kawai zuba wannan magani a cikin awa biyu zuwa huɗu zai rage hauhawar — hasashe da marubutan suka lura cewa ƙarin huda yatsa ɗaya zai iya gwadawa.

Madadin da ba a gwada ba, da sharuɗɗansa

Marubutan sun ba da shawarar maye gurbin allurar gyara da zubar insulin ta jijiya ba tsayawa da aka haɗa da dextrose, ta yadda za ta tsaya a duk lokacin da ciyarwa ta tsaya, ana daidaita ta sau ɗaya a rana bisa matsakaicin sukarin ranar da ta gabata, da ceto kawai idan ya sauka ƙasa da mg/dL 70. Ba su san wata ƙa’ida da aka wallafa irin wannan ba, kuma sun bayyana cewa ba a gwada ta ba. Sun kuma lura cewa matsakaicin mara lafiyar, mg/dL 145, ya riga ya kasance cikin burin asibiti na yau da kullum.

Iyakokin suna da girma, kuma marubutan sun lissafa su: mara lafiya ɗaya; kowace lamba sakamakon samfuri ne; ba a taɓa auna yadda jikinta ke jin insulin ba (insulin sensitivity); kuma wani magani da aka ba ta zai iya sa wasu takardun gwajin sukari su nuna karatu mai yawa na ƙarya — ba a duba irin takardar ba, don haka dukkan bayanan na iya karkata zuwa sama.

Rikicin moriya. Marubutan biyu ’yan uwan mara lafiyar ne. Su ne masu Regev Labs, LLC, wanda ke da buƙatar haƙƙin mallaka na wucin gadi (provisional patent) a Amurka kan samfuran sukari na musamman ga kowane mara lafiya da ƙa’idojin gyaran insulin, da wata ta biyu kan tsara zubar insulin. Ba a nemi bitar kwamitin ɗa’a ba; iyayen mara lafiyar sun ba da izini a rubuce don wallafawa kuma mara lafiyar ta amince a rubuce. Wannan labarin yana bayyana samfuri ne, ba shawarar likita ba.