Availability of Animal Insulin if You Are Admitted to Hospital
GM Vs animal insulin
Choices – The Evidence
Evidence from people with diabetes
A little bit of history
Facts
Action and duration times of animal and GM ‘human’ insulins
Hypoglycaemia and loss of warnings
‘Dead in Bed Syndrome’
The concerns of patients are justified
Availability of animal insulins in the UK
Changing your insulin
What to do if your consultant refuses to change your insulin
Availability of animal insulin if admitted to hospital
Frequently asked questions
Allergic reactions to insulin
Availability of animal insulin if admitted to hospital
Many of our members who use animal insulin have expressed real concerns about if they are admitted to hospital, especially in emergency or if they are unconscious. They report that they have had to argue to remain on their usual animal insulin or they have been changed to GM ‘human’ or analogue insulin, even against their expressed wishes. Some people have felt that a hospital admission was seen as the opportunity to change this ‘non-compliant’ patient to GM ‘human’ insulin. It may simply be that the hospital doesn’t stock animal insulin.
Note: All major pharmaceutical wholesalers in the country stock Wockhardt Hypurin insulins and they should be available to any hospital within 4 hours, except at weekends.
IDDT advice:
- If it is a pre-planned stay in hospital, then ensuring that you remain on your usual insulin should be organised at consultations before you go into hospital. You should always take your own insulin with you.
- The difficulties arise if you enter hospital in emergency, unconscious and unable to speak for yourself. If possible, make prior arrangements to try to ensure that a member of your family speaks for you and takes your usual insulin to the hospital as soon as possible.
IDDT has taken action on this matter:
IDDT supplies special stickers for hospital and GP notes for people who are concerned about GM ‘human’ or analogue insulins being administered without their consent. The stickers say: ‘This patient does not consent to the administration of ‘human’ insulin.’
Contact IDDT for your supply of stickers.
In April 2000 IDDT wrote to the Chief Executives of all hospitals in the UK to request that their pharmacy departments stock beef and pork insulins, especially for emergency hospital admissions. We pointed out that around 30,000 people in the UK are still choosing to use animal insulins and at any time any of these people could be admitted to hospital and need animal insulin. There were mixed responses to this request, some were very supportive and made a policy decision to stock animal insulins but some were dismissive!
IDDT wrote to the General Medical Council [GMC] and their general advice was:
"We always expect doctors to act in the best interests of their patients and to listen and respect their views and their right to be fully involved in decisions about their care. We also expect doctors to be satisfied that, wherever possible, the patient has understood what is proposed, and consents to the treatment.
We advise that in an emergency, where consent cannot be given, the doctor provides medical treatment to anyone who needs it, provided the treatment is limited to what is immediately necessary to save life or avoid significant deterioration in the patient’s health. However, the doctor must still respect the terms of any valid advance refusal which he/she knows about or has been drawn to his/her attention. The patient must be told what has been done and why as soon as he/she is sufficiently recovered to understand."
So applying this advice to treatment with animal insulin, the GMC recommend that your wishes should be respected. However, if animal insulin is unavailable, and you need insulin in emergency, eg if you were hyperglycaemia, then ‘human’ insulin could be administered to save your life or prevent further problems. But once recovered, you should be told of this and your wishes to return to animal insulin should be respected. This GMC advice makes it clear that you should have it recorded in all your medical notes that you do NOT want ‘human’ insulin administered – hence you have complied with the advance refusal referred to.