Insulin deficiencies ‘causing stress and anxiety’ for British diabetes patients
People with type 1 diabetes are being forced to endure the ‘stress and anxiety’ of insulin shortages, patients, pharmacists and health campaigners have warned.
The ‘dire’ drug shortage, the latest to hit Britain, is creating uncertainty for the 400,000 people with the condition, with some products not available again until next year due to global production shortages.
Britain is already struggling with a record number of medicines that are difficult or impossible to obtain, including drugs for attention deficit hyperactivity disorder and epilepsy.
The Juvenile Diabetes Research Foundation (JDRF) said that “a regular and reliable supply of insulin is essential for life” for type 1 diabetics. That’s because their disease – an autoimmune condition unrelated to type 2 diabetes – means they can’t produce insulin naturally and must inject it or receive it through a pump every day.
“People with type 1 diabetes must manage their own insulin injections and dosing, so it is imperative that they have confidence in the delivery of their regular type of insulin,” said Hilary Nathan, director of policy for the JDRF.
“The news of possible shortages could cause great concern for people with type 1 diabetes.”
The Department of Health and Social Care (DHSC) confirmed there were “supply issues with a limited number of insulin products” which patients may find “concerning”.
One patient, an NHS doctor who puts vials of the drug into her insulin pump, said: ‘I have been trying to get hold of insulin for the past two days to treat my type 1 diabetes. I was terrified when my usual, very reliable pharmacist told me he couldn’t get my insulin.
“I had no idea that insulin could be out of stock. Type 1 diabetics get sick and die within a few days without insulin. I worry for fellow diabetics, not only about accessing supplies to stay alive, but also about the stress and anxiety this causes.”
She had to call numerous pharmacies in her city before finally finding one that still had bottles of Humalog, her usual form of insulin, and getting a new supply. Eli Lilly, the US company that makes Humalog, said last month that it is a different form of the drug Temporarily out of stock.
Nathan said any shortage of vials is “of particular concern because people who use pumps to deliver their insulin rely on these forms of the drug.” If you have to switch to an insulin pen instead because vials are not available, “it could be extremely disruptive and distressing to (a patient’s) daily life.”
In addition to Humalog, two other insulin formulations – Fiasp FlexTouch pre-filled injection pens and Tresiba FlexTouch pens – are also in short supply. Neither is expected to be available again until early next year. Two other forms of insulin have recently been discontinued.
In a report published earlier this month, the Nuffield Trust warned that medicine shortages were a “new normal” in Britain and that Brexit was making the situation worse.
James Davies, director of the Royal Pharmaceutical Society for England, said: “Understandably, if there is a supply problem with insulin medicines it can make people very worried as they and their relatives rely on their medicines to stay healthy.
“If someone is unable to get the medications they need, it can endanger their health and destabilize their condition.”
The NHS has sought to reassure type 1 diabetics that they can use other formulations when their usual product is not available. But a small number of people have experienced problems as a result of being given ‘inappropriate dosage advice’ when switching. Among them was one who was in hospital with ketoacidosis – a potentially life-threatening side effect of type 1 diabetes – according to a national patient safety alert released in December.
“The impact of medicine shortages on patients and our community pharmacies remains a major concern. It is a struggle to keep up with the large number of medicine supply issues,” said Mike Dent, director of pharmacy finance at Community Pharmacy England.
“The shortages faced by various medicines, including anti-epileptic drugs, insulins and certain diabetes treatments, not only impact the timely provision of medicines, but also place enormous operational and financial pressure on community pharmacies.”
Paul Rees, the chief executive of the National Pharmacy Association, said the scarcity of some insulin products “underlines the precarious nature of the medicine supply – even for life-threatening conditions”.
He added: “We urgently need the government to fix Britain’s fragile medicines supply system.”
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 resolve these. We have also provided comprehensive guidance to the NHS on these supply issues, providing advice on how patients should be treated during this period.
“We know that shortages can be distressing for patients and families, and we advise any patient who is concerned about their condition to speak to their doctor.”