Alarm over shortage of life-saving insulin as GP warns ‘type 1 diabetics fall ill and die in days without it’
PEOPLE with type 1 diabetes fear their lives could be at risk as the UK faces shortages of “vital” insulin.
Insulin, which helps the body regulate blood sugar levels, is one of hundreds of drugs currently hard or impossible to get in the UK.
Experts say a “regular and reliable” supply is “essential for life”, warning the shortages will cause “anxiety” for the 400,000 Brits with type 1 diabetes.
However, some patients have told how they’ve been unable to get vials of vital insulin from local pharmacies or been encouraged to switch brands, which can be dangerous if done incorrectly.
Hilary Nathan, director of policy at the Juvenile Diabetes Research Foundation, told The Sun: “Any changes to prescriptions or reported shortages of insulin will be a cause of significant worry to people.
“Insulin is vital for life, and people with type 1 must dose themselves with insulin every day.
“There are many different types of insulin available and each of them work in a different way in each person’s body.
“They vary in the time they take to start working, when they peak and how long they last.”
She added: “When someone with type 1 finds the right insulin for their lifestyle and learns how to make it work for themselves, which can take time and a lot of tweaking, a regular and reliable supply is essential.”
It’s ridiculous that such a basic medicine is unavailable
Manisha Vadgama
The Department of Health and Social Care (DHSC) confirmed there were “supply issues with a limited number of insulin products” that patients might find “distressing”.
Manisha Vadgama, a teacher in Harrow, was forced to wait three weeks to get hold of insulin to treat her diabetes.
“It made me extremely stressed and caused a lot of necessary anxiety – two things known to make diabetes worse,” she told Sun Health.
“It’s ridiculous that such a basic medicine is unavailable.”
“Not being able to get hold of the medicines can put us diabetics in a very dark place; after all, they do keep us alive.
Hard to switch brands
While she waited, the 37-year-old was encouraged by pharmacists to switch to another brand of insulin that wasn’t in short supply.
“It takes ages to adjust to a new medicine; I’m a teacher; I don’t have time for that.”
NHS England has advised the 400,000 Brits living with the condition to use other brands if their regular medication is unavailable.
Hilary, however, said: “Any changes to the type of insulin offered on prescription can have a serious impact on the way that someone with type 1 can continue their everyday activities.”
It comes as a small number of people have reported encountering difficulties after being given “inappropriate dosing” advice when they switched.
They included one who was hospitalised with ketoacidosis, a potentially life-threatening side-effect of type 1 diabetes, according to a national patient safety alert.
One patient, an NHS doctor who puts vials of the drug into her insulin pump, told The Guardian: “I spent the last two days trying to get hold of insulin to treat my type 1 diabetes.
“I was terrified when my usual, very reliable pharmacist told me he couldn’t get hold of my insulin.
What are the symptoms of type 1 diabetes?
See a GP if you have symptoms of type 1 diabetes, including:
- Feeling very thirsty
- Peeing more than usual, particularly at night
- Feeling very tired
- Losing weight without trying
- Thrush that keeps coming back
- Blurred vision
- Cuts and grazes that are not healing
- Fruity-smelling breath
Type 1 diabetes symptoms can come on quickly, particularly in children.
Source: The NHS
“I had no idea that insulin could go out of stock.
“Type 1 diabetics fall ill and will die within a few days without insulin.”
Both Manisha and the NHS doctor had to ring various local pharmacies before tracking down one with stocks of Humalog vials, their usual form of insulin.
‘Most’ common types of insulin are ‘unavailable’
As well as Humalog, two other insulin formulations – Fiasp FlexTouch pre-filled injecting pens and Tresiba FlexTouch pens – are also in short supply.
Neither is expected to become available to patients again until early next year.
Two other forms of insulin have been discontinued recently.
Dr Leyla Hannbeck, chief executive of the Association of Independent Multiple Pharmacies, told Sun Health that “most” common forms of insulin are “unavailable” for pharmacists to order.
“We are having a lot of issues in pharmacies trying to source them, and it is causing a lot of stress for patients,” she said.
“This is part of the ongoing medicines supply issues which we have for months and months”.
In a report published this month, the Nuffield Trust warned that drug shortages were a “new normal” in Britain and that Brexit making it worse.
Around 220,000 Brits live with type 1 diabetes, including actor James Norton and former Prime Minister Theresa May.
Unlike type 2 diabetes, there is nothing you can do to prevent yourself or others from developing type 1 diabetes.
The lifelong condition destroys cells in the pancreas that produce the hormone insulin, which helps control blood sugar levels.
Patients normally have to monitor their blood sugar throughout the day and inject themselves with the hormone to keep levels in check.
Over time, fluctuating blood sugar levels can also lead to a range of long-term complications, including permanent eye problems and nerve damage, which can result in the loss of limbs.
Douglas Twenefour, Head of Care at Diabetes UK, said: “We’re aware of a number of shortages involving medicines used by people with diabetes in the UK.
“However, in all cases, suitable alternatives, including insulin, are available.
“We know it can be unsettling if people have to change how they manage their diabetes.
“With this in mind, we’re asking healthcare professionals to take into account the circumstances and needs of anyone affected.
“This should include a discussion to ensure they can continue to manage their treatment, and should include a prescription for any new device they need.”
A DHSC spokesperson said: “We are aware of supply issues with a limited number of insulin products and are working with the respective manufacturers to help resolve them.
” We have also issued comprehensive guidance to the NHS about these supply issues, which provides advice on how to manage patients during this time.”
“We know that shortages can be distressing for patients and families, and we advise any patient who is worried about their condition to speak to their clinician.”
Which medicines are affected?
There are some temporary shortages involving medicines used by people living with diabetes in the UK
This includes:
Humalog
Currently there is the potential for short-term disruption to supplies of Humalog vials.
This applies to the Humalog insulin in vials only – pre-filled pens and cartridges are not affected.
The affected vials are Humalog 100u vials, Humulin M3 vials and Humulin S100 vials.
Eli Lilly, the manufacturer of Humalog, says they are actively monitoring this situation and are working to reduce the impact of supply disruptions.
“Anyone experiencing difficulty in getting their prescription filled should contact their doctor to discuss options,” a spokesperson for Eli Lilly said.
“People who need insulin immediately and cannot access their doctor for an alternative treatment option should seek emergency care.”
Fiasp FlexTouch
There are no shortages of Fiasp insulin, but it is expected that a shortage of the Fiasp FlexTouch 100units/ml pre-filled insulin pen will last until January 2025.
Novo Nordisk manufactures Fiasp in 100units/ml cartridges (Penfill), which remain available.
Your healthcare team might give you the option of continuing to use this insulin in cartridge form.
Tresiba FlexTouch
Similarly to the situation with Fiasp, there are no issues with availability of Tresiba insulin, but there are supply issues with the Tresiba FlexTouch 100units/ml pre-filled pens.
The Department of Health and Social Care expects Tresiba FlexTouch 100units/ml pens to be out of stock in the UK until December 2024.
Your healthcare team might give you the option of continuing to use Tresiba insulin in cartridge form.
InnoLet
In March 2024, the Department of Health and Social Care issued a Medicine Supply Notification for Novo Nordisk’s InnoLet 100units/ml suspension for injection 3ml.
These pre-filled disposable devices are being discontinued and remaining stock is set to run out by the end of May 2024.