IDDT campaigning

Pork and beef insulins available in the UK
Synthetic ‘human’ insulin versus natural animal insulin
Animal insulin – Minister’s letter
Limiting availability of blood glucose test strips

 

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Limiting availability of blood glucose test strips

IDDT continues to receive reports about restrictions on the numbers, or total refusal, to prescribe blood glucose test strips. These reports are usually from people with Type 2 diabetes whether or not they are on insulin but we are also receiving similar reports from people with Type 1 diabetes.
The attitude to prescribing of strips varies from area to area but when this is limited or denied altogether, it is a cost-based decision resulting in post-code prescribing of blood glucose test strips.

Opposing views from the medical profession!
“People with type 2 diabetes should have as many test strips as they like.”
This is the view of Dr Richard Greenwood, consultant at the Norfolk and Norwich University Hospital, reported in The Eastern Daily Express [13.4.04] who says:
“My view is that people with Type 2 diabetes should be offered as many tests as they would like. A lot of patients feel more comfortable if their blood test is normal. There is a reassuring element with these strips which is very important with a condition like diabetes. This is where evidence based medicine and what patients want is at odds. I think PCTs are taking the health economics approach and trying to reduce expenditure whereas they should take a more humanitarian approach.”

But Coventry GP, Dr Rodney Swallow says:
“Some patients are testing themselves at home more often than they need to and perhaps it is becoming an automatic thing. We are not saying that people should not test themselves, it definitely has its uses and it is a basic part of monitoring and treatment, if it is done correctly. Some people may be testing four or more times a day, everyday which is unnecessary. Too much testing can be scary, especially for older people who may become more anxious about their condition. Too much testing can lead to a lot of soreness of the fingers.”

IDDT’s advice:
If you are denied the glucose test strips you need, you should take this up first with your GP and or GP practice manager and if this fails, with the Primary Care Trust.
The following information may be useful in your discussions:

• The Minister has confirmed that blood glucose test strips are available on the NHS and there are no plans to discontinue this arrangement.
• It was on the recommendation of diabetes specialist that blood glucose testing was advised in the first place and not a mere whim of patients. If you feel safer using test strips, then explain this when making your case.
• The National Service Framework for Diabetes aims to increase patient empowerment and make them more responsible for their own treatment and care, restrictions on strips is not in line with these principles.
• There is no evidence that blood glucose testing actually improves diabetes control but Dr Greenwood highlights the needs of patients to have the assurance and comfort of knowing what their blood glucose levels so that they can take the necessary action.

www.diabeteschoices.org.uk – A useful source of information about food and drinks for people with Type 2 diabetes.

www.nhs.uk – the NHS Online is the country’s biggest health website and gives all the information you need to make choices about your health.

www.myageingparent.com – A resource for everything you need, or want to know about elderly care. This includes positive ways to keep ageing parents, friends and relatives active and healthy, maintaining their finance and legal needs to information on care options, local authority funding and managing age-related health issues.

www.associationfornutrition.org – The Association for Nutrition (AfN) defines and advances standards of evidence-based practice across the field of nutrition and at all levels within the workforce. We protect and benefit the public by Championing Registered Nutritionists (RNutr), whose entry onto the UK Voluntary Register of Nutritionists (UKVRN) is an assurance that they meet our rigorous standards of competence and professionalism; Supporting frontline health and social care workers with essential tools which enable individuals to evaluate and enhance their nutrition competences; Recognising high quality, relevant nutrition training through our Course Accreditation, CPD Endorsement and Certification schemes.

www.voyagemd.com – VoyageMD has been created to provide information for people travelling with diabetes.

www.myageingparent.com – Securing the future of antibiotic development… determined to make a difference.

MedicAlert is a global charity that provides medical ID jewellery for people with hidden medical conditions or allergies. Situated on the pulse points, it displays the international medical symbol to quickly identify your condition and speed up treatment in an emergency. Because every moment matters.

MedicAlert members benefit from peace of mind that goes far beyond their bracelet. Their conditions are reviewed by medically trained staff, who prioritise the text engraved on each piece of jewellery. A detailed medical record is also held in our secure database, which can be accessed 24/7 by emergency responders.

www.FocusOnDiabetes.nihr.ac.uk – the National Institute for Health Research website about diabetes features interviews with researchers into diabetes and includes resources for patients interested in taking part in research.

www.modernes-tierisches-insulin.de – German diabetes.

www.sugar-sweet.de – German site for animal insulin.

onlinepharmacycheck.com/~doc/facts-about-ua – IDDT’s Facts About Diabetes translated into Ukrainian

www.youtube.com/watch?v=tYlQTylh_0M&feature=player_embedded – ‘I’m Type 1 Aware: Are You?’ video by JDRF and Diabetes UK.

www.qub.ac.uk/elearning/public/WomenWithDiabetesThingsYouNeedToKnow/ – A very useful website raising awareness of reproductive health among women with diabetes.

Calibre audio Library – If you suffer from diabetic retinopathy you may have trouble reading print books this is where Calibre Audio Library can help.

www.spirit-healthcare.co.uk – Spirit Healthcare are an innovate Healthcare Retailer working to improve the quality of life for individuals with a range of long term conditions including diabetes. With the CareSens Blood Glucose Meter and the Mission Urine Testing range Spirit Healthcare have both products and resources available to help individuals with diabetes.

www.sugarbalance.co.uk/ – a useful site about ‘Sugar Balance programme’ run by Nic Lee, a diabetes coach and counsellor who has Type 1 diabetes. It aims to simplify the process of managing the highs and lows.

www.drugwatch.com – Drugwatch.com is a US-based comprehensive Web site featuring extensive information about thousands medications and drug side effects.

go.qub.ac.uk/womenwithdiabetes – a preconception counselling website developed in partnership with women with diabetes to raise awareness of the importance of reproductive health in women.

www.gsf-syrup.co.uk – a syrup for treating hypoglycaemia in orange, tropical and mint flavours. It is available on prescription for people with diabetes.

www.glucogel.co.uk– A useful gel for treating a hypo.

thependseytrust.org/ – The Pendsey Trust aims to provide access to education for those affected by diabetes in developing countries in the hope that this will enable these individuals to enter employment and support themselves into a healthy, more certain future.

www.carers.org– A carer is someone of any age who provides unpaid support to family or friends who could not manage without this help. Carers need support too, so visit this useful site.

www.drwf.org.uk – Diabetes Research and Wellness Foundation is a registered charity whose long-term mission to to discover a cure for diabetes and in the meantime, to support, advise and educate people with diabetes and the general public.

www.diabetesbible.com – practical guidance for health professionals on diagnosing and treating diabetes.

www.expertpatients.co.uk – Expert Patients Programme (EPP) courses are FREE and help people to improve their health and wellbeing by learning new skills to manage their condition on a daily basis. People who have already attended courses have told us it has helped them to deal with their pain, tiredness, feelings of depression, frustration and other difficulties that may come from living with a long-term condition.

www.guyculverwelltrust.com – Young people raising money for IDDT in memory of their friend, Guy Culverwell.

http://instituteofdiabetes.org/ – The Institute of Diabetes for Older People (IDOP) is a non-profit making, research and academic institution, based at the University of Bedfordshire, dedicated to enhancing the health and well-being of all older people with diabetes and related metabolic illness.

www.nmsociety.org – Useful website looking at the benefits of lowering carbohydrate intake.

www.glycosmedia.com – A free and editorially independent diabetes news service with the latest diabetes news and information for professionals and patients wishing to keep abreast of latest developments.

www.lindalliance.org – IDDT is affiliated to the James Lind Alliance which aims to identify the most important gaps in knowledge about the effects of treatments, and has been established to bring patients and clinicians together in ‘Working Partnerships’ to identify and prioritise the unanswered questions that they agree are most important.

www.friouk.com – if you are travelling to hot climates, Frio Wallets keep your insulin cool.

www.equip.nhs.uk – A source of good quality information.

www.cardiacmatters.co.uk – a single source of  information about the causes, symptoms and treatments of a range of heart conditions.

www.invo.org.uk – INVOLVE is funded by the Dept of Health to Promote and support active public involvement in NHS, public health and social care research. INVOLVE believes that involving members of the public leads to research that is more relevant to people’s needs and concerns, more reliable and more likely to be used.

www.owenmumford.com – Information about Owen Mumford’s medical devices including the AutoPen for use with animal insulins.

www.unistik3.com – Information about Unistik 3, a single use safety lancet is designed to make lancing less painful and is now available on prescription. Free samples are available, so people can try the Unistik 3 for themselves.

www.medipal.org.uk – Order online a MediPal medical ID card which provides immediate access to your medical details in case of emergency.

www.glucosemeters4u.com – Learn about Diabetic products.

www.rch.org.au/diabetesmanual/index.cfm?doc_id=2352 – Available free on-line an Australian Diabetes Manual for Parents manual from Westmead Children’s Hospital and the Royal Children’s Hospital – very useful for parents of children with Type 1 diabetes.

www.retinalscreening.nhs.uk/pages/default.asp?id=3&sID=135&cP=202 – This link will help you to locate and contact the local retinal screening programme responsible for your retinal screening. You can confirm which your screening programme is by contacting them using the contact details listed on the site.

www.hospitalhelp.co.uk – An independent website offering help to people going to hospital.

www.medicalshop.co.uk – Medical Shop is a mail order service for people with diabetes. It is possible to buy products online and over the ‘phone as well.

www.diabeteshealth.com/insulin – Diabetes Health presents a well-balanced and detailed article asking: “Where Have All the insulins Gone?” and “How Good and Safe are the Remaining Options?”.

www.radrr.com – Take a look and buy insulin pump covers that are ‘cool’ and durable for the toughest kids.

www.RemedyFind.com – RemedyFind is a free and unbiased site, not sponsored by any drug companies, that allows people to rate the effectiveness of the treatments they have used for specific health conditions. The site covers about 60 conditions and has 95,000 members.

www.yellowcard.gov.uk – The Dept of Health website for reporting adverse drug reactions and viewing those already made – now available to patients as well as health professionals.

www.dvla.gov.uk – The Driver and Vehicle Licensing Agency website that provides information about driving and diabetes.

www.wockhardt.co.uk – UK suppliers of pork and beef insulins in vials and cartridges.

www.diseasesconditions.com -Directory of information.

www.insulin-pumpers.org.uk – An essential visit for those contemplating using an insulin pump.

www.patients-association.com – Welcome to the Patients Association Website. Within this site you will find out what we do and will be able to let us have your thoughts on health care in the UK.

www.getcanadadrugs.com – An online sources or pork insulins that does nopt require a doctor’s letter, useful for people in the U.S.

www.xe.net – If you want to import insulin and need to convert currencies.

www.lilly.com – Eli Lilly website.

www.novonordisk.com – Novo Nordisk website.

www.nkfg.org – National Kidney Foundation.

www.neuropathy.org – Neuropathy Association.

www.feetforlife.org – Well worth a visit to learn how to care for your feet.

www.desang.net – Kitbags and organisers for people with diabetes to use to carry all their tools with them as they go about their normal daily lives.

www.jdrf.org.uk – Provides information about the progress of diabetes treatments and research as well as information on different aspects of living with diabetes, extremely useful to health professionals.

www.self-help.org.uk – Self Help UK provides a searchable database of over 1000 self help organisations and support groups across the UK that offer support, guidance and advice to patients, carers, and their relatives.

www.diabeticshop.co.uk – This site is designed to help people living with diabetes obtain products and services that can assist a diabetic in living a more natural daily life.

www.arcticmedical.co.uk – Arctic Medical supply a comprehensive range of diabetes care products, including a wide range of diabetes bags.

An umbrella organisation
Canada
Germany
New Zealand
United States

An umbrella organisation

In the years following the formation of IDDT in 1994, membership and independent financial support for IDDT in the UK increased. IDDT was contacted by people in many different countries, all experiencing problems with GM ‘human’ insulin. As a result of this in 1999 an umbrella organisation, IDDT-International, was formed. This has enabled individual people in different countries to form groups and link together to exchange information, to unite to gain recognition of the adverse reactions to ‘human’ insulin suffered by some people and to campaign for the availability of easily accessible animal insulin.

Pharmaceutical companies and the medical profession function on international levels, giving them both greater influence, power and control. For patients to even attempt to have an equal partnership in healthcare, they must unite, function and be represented internationally, so patients now have an international umbrella organisation, IDDT- International, that can function on a global basis to protect and represent their interests.

While the situations in various countries are different, the principles involved for us all are the same. We must work together to acquire the power to ensure that we succeed in achieving our ultimate goal – the right of people to have the species of insulin they need for their future health and wellbeing and to have a fully informed choice of treatment.

Goals

• To offer care and support to people with diabetes and their family carers, especially those experiencing difficulties with GM synthetic ‘human’ and analogue insulins.
• To ensure that natural porcine and bovine insulins remain available indefinitely for those who need them and to resist the systematic withdrawals of animal insulins and to ensure that regulatory bodies are made aware of these problems.
• To enable people to have an informed choice of insulin treatment best suited to their individual needs. To disseminate information about synthetic and animal insulins to all those requiring insulin treatment, especially the newly diagnosed who are often not made aware of the availability of animal insulins or the possible adverse effects of GM ‘human’ insulin.
• To assist in establishing the most efficient systems for personal importation into countries where animal insulins have been withdrawn and to help to disseminate this information directly to patients and their families.
• To raise awareness and resist the situation that has developed, where prescribing now appears to be dictated by the pharmaceutical companies and their commercial interests and NOT by the clinical needs of patients.
• To try to ensure that independent, large scale, long term, methodologically correct research is carried out into all the reported problems with GM ‘human’ insulin so that insulin treatment is evidence based.
• To remain financially independent of pharmaceutical companies and especially insulin manufacturers.

Information and publications
Since 1994 we have widened our interests and concerns to cover many aspects of living with diabetes and this is largely as a result of the expressed wishes of our members and people who contact IDDT.

However, ensuring that people with diabetes receive information and the choice of treatment, especially the type of insulin, remains our main concern. We hope that IDDT can provide people who live with diabetes with information, support and encouragement to be involved in decisions about their healthcare and that we can assist them to be able to make informed decisions about their treatment, especially about their choice of insulin.

For more general information about diabetes and associated issues, go to our Home Page

For more information about how to receive the quarterly Newsletter and free IDDT information leaflets click here.

Or to request leaflets or for further information:

InDependent Diabetes Trust
PO Box 294
Northampton
NN1 4XS
tel:01604 622837
e-mail: [email protected]
website: www.iddtinternational.org

IDDT Canada

Welcome to IDDT Canada
Global systematic withdrawal of animal insulins
Wockhardt UK pork insulin’s are available in Canada
Hypurin pork insulin – assurance of continued availability

 

Back to IDDT International

Welcome to IDDT Canada

IDDT is a UK organisation set up in 1994 to help and support people with diabetes who need natural animal insulins. This sub-group of people with diabetes cannot use synthetic so-called ‘human’ insulin because of adverse effects on their health and quality of life.

The aims of the Trust are:

• To help and support people with diabetes who cannot use synthetic ‘human’ insulin.
• To try to ensure that natural animal insulins remain available for the people who need them.
• To provide information about the availability of animal insulins.
• To seek recognition of the difficulties that a significant minority of people have when they are treated with synthetic ‘human’ insulin.
• To represent, and lobby on behalf of, this group of people to ensure that they have the natural animal insulin they need to retain good health and a good quality of life.  

IDDT – Canada
The withdrawal of beef insulin by Eli Lilly in Canada and later the withdrawal of pork insulin led to the formation of IDDT-Canada by Carol Baker, who says:

"One of my concerns is that any choice of insulin is being eliminated. I no longer have a choice locally or nationally to buy the insulin that is best for me. It has been arbitrarily removed. Nobody asked me!"

Introducing Carol Baker

Carol lives in Victoria, British Columbia and has had insulin dependent diabetes since 1959. She used beef insulin until 1987 when she tried using synthetic ‘human’ insulin.

She says, ‘I tried it for several months and found that my glycaemic control just went on holiday! Also on ‘human’ insulin I found that my warning signs of low blood sugar were so subtle that I often didn’t notice until I reached dangerously low levels. I returned to beef and I am still using it today. My early warning signs have returned and my HbA1c levels [the blood test that shows the average blood sugars over the last few weeks] are at a very reasonable level. I work hard at good control as I want to continue to avoid any complications of my Type 1 diabetes.’

In 1998 when Eli Lilly announced that they were stopping production of their beef/pork insulin, Iletin1, Carol was deeply concerned and started to look around for a supply for her future needs. She contacted IDDT in the UK and discovered that in the UK, CP Pharmaceuticals Ltd [now Wockhardt UK] supply both beef and pork insulins and not only in vials but also in cartridges for use with a pen injection device. She also realised that there were many other people in Canada in a similar situation to herself who needed animal insulin, help and information. She recognised that they needed representation and an organisation through which their views and experiences could be expressed to Health Canada, the medical profession and the pharmaceutical companies. Carol believes that it is essential that people with diabetes unite on this issue to ensure that they have the choice of insulins they need to control their diabetes safely and effectively, while at the same time maintaining a good quality of life.

So ‘IDDT-Canada’ was formed!

Carol will be delighted to hear from you so if you would like:

• more help and information,
• to exchange and share experiences,
• to offer your support,

Contact Carol Baker at:
1021 Dundas Street
Kamloops, BC V2B 2T1
Canada

Tel: 1 (778) 470 6444
e-mail: [email protected]

IDDT Canada

Welcome to IDDT Canada
Global systematic withdrawal of animal insulins
Wockhardt UK pork insulin’s are available in Canada
Hypurin pork insulin – assurance of continued availability

 

Back to IDDT International

Global Systematic withdrawal of animal insulins

There are two major suppliers of animal insulins, the Danish company Novo Nordisk and the American company Eli Lilly have systematically withdrawn their ranges of natural beef and pork insulins from countries around the world. This ‘forces’ people to use ‘human’ or analogue insulins, despite the reported adverse reactions it produces for this significant minority of people who require natural animal insulin to treat their diabetes.

What are the problems that some people experience with ‘human’ insulin?

The most common complaint from people who have problems with ‘human’ insulin is loss or partial loss of warning symptoms of an impending hypo and an increase in the numbers of hypos. This is also confirmed by the information in the leaflet inside packs of ‘human‘ insulin. IDDT has received reports from people with diabetes and their families in many countries and the greatest concern for them about ‘human’ insulin is hypo unawareness. Hypoglycaemic unawareness is an unsafe condition that can lead to severe hypoglycaemia resulting in unusual, irrational or violent behaviour, coma and seizures.
A survey carried out by IDDT in the UK showed that the difficulties for this group of people experienced were as follows:

• 41% – loss of warnings of hypos or ‘I seem to function on automatic pilot’.
• 34% – extreme tiredness or lethargy
• 9% – sleeping all the time
• 32% – weight increase of 1.5 stones and above
• 28% – feeling unwell all the time
• 24% – memory loss or confusion
• 9% – blood glucose levels dipping and peaking erratically
• 8% – described by their families as ‘not the same person’
• 5% – mood changes, described as difficult to live with
• 7% – pains, especially ion the legs and joints
• 4% – irregular or late periods

In addition to this 24% 0f those contacting IDDT said that their doctor was unwilling or reluctant to change their insulin to natural animal insulin and 3% told us their doctor didn’t listen or said the problems were ‘all in the mind’.
Other common statements were:

• ‘I didn’t know that there was such a thing as animal insulin.’
• ‘I was never told there were alternatives’.
• ‘I didn’t realise that ‘human’ insulin was not derived from humans’.

Note – These findings confirmed the results of an unpublished study carried out by the British Diabetic Association [now Diabetes UK] looking into the unsolicited letters they received from nearly 3000 people reporting problems with ‘human’ insulin.

IDDT Canada

Welcome to IDDT Canada
Global systematic withdrawal of animal insulins
Wockhardt UK pork insulin’s are available in Canada
Hypurin pork insulin – assurance of continued availability

 

Back to IDDT International

Wockhardt UK pork insulins are available in Canada

September 2007

Following Lilly’s discontinuation of pork insulin in April 2006 in Canada, Health Canada gave licensing approval to Wockhardt UK to distribute Hypurin Pork insulins throughout Canada.

Wockhardt supply the following insulins:
Hypurin Pork Regular in vials
Hypurin Pork NPH in vials

---

 

How to obtain pork insulin in Canada (April 2019)
There have been reports that some pharmacies are not supplying people with NPH and Regular pork insulin. The main distributors are McKesson but this company appears to be having some difficulties and people are being told that they are out of stock, which is causing some people to panic, not unreasonably.

For the present time, this is how to proceed:
1. People who rely on one of the larger commercial pharmacies should request them to submit a “Request to Order” to a company called Kohl & Frische which will obtain the insulin from Nucro-Technics. They will need to order a minimum of 4 vials (such as 2 NPH, 2 Regular) otherwise it’s too expensive to supply it.

2. If they use a smaller, independent pharmacy they can advise them the insulin is available directly from Nucro-Technics in Toronto. The pharmacist can contact the company and ask for Pamela who is the one who seems to be on top of everything. Her contact number is 416 438-6727.

3. To address the immediate issue, Health Canada had suggested that individuals could go through the Special Access Program to obtain the needed insulin but this is unacceptable so Nucro-Technics is ion discussion with Health Canada about a long-term solution.

We will try to keep you informed of any further changes.

If IDDT can be of help, please e-mail:

Carol Baker – IDDT Canada
e-mail: [email protected]

or

Jenny Hirst – IDDT UK
e-mail: [email protected]

IDDT International

An umbrella organisation
Canada
Germany
New Zealand
United States

IDDT in Germany

IDDT’s contact in Germany is Sabine Hančl.

Sabine was diagnosed with Type 1 diabetes in 1963 when she was nine years old. She has an allergy to synthetic human insulin and so is entirely reliant on animal insulin which is manufactured in the UK.

For information about animal insulin and availability in Germany, visit the following website:
www.modernes-tierisches-insulin.de

Sabine’s details are as follows:
Fon +49 6106 644880
Fax +49 6106 644881
email: [email protected]

IDDT International

An umbrella organisation
Canada
Germany
New Zealand
United States

IDDT in New Zealand

IDDT does not have a formal group in New Zealand but we do have members who live in New Zealand and we are aware that some people suffer the same adverse effects of ‘human’ insulin that are experienced by people in other countries. So some people in New Zealand need beef and pork insulins.

Insulin Availability in New Zealand
People are automatically treated with genetically produced human or analogue insulins as animal insulins are not available in New Zealand. Pork insulin can be imported on the ‘importation for personal use basis’, as used by people in other countries.

The details of how to import pork insulins can be found by visiting Wockhardt’s website: www.wockhardt.co.uk

Or you can contact Wockhardt UK as follows:
Wockhardt UK Ltd
Ash Road North
Wrexham Industrial Estate
Wrexham LL13 9UF
UK
tel: +44 1978 661261
fax: +44 1978 660130

IDDT United States

Welcome to IDDT – US
Global systematic discontinuation of animal insulins
Personal importation of pork insulin in the US no longer possible

 

Back to IDDT International

Welcome to the IDDT US

The InDependent Diabetes Trust (IDDT) is a registered charity [not-for-profit organisation] which formed in 1994 in the UK by people that live with diabetes for people that live with diabetes. Perhaps this is where we differ from other diabetes organisations – we know from experience the difficulties, the worries, the fears and the sense of achievement when things are going well. We are concerned with listening to the needs of people who live with diabetes, understanding those needs and doing our utmost to offer help and support. We not only want to help those who actually have diabetes but also their caregivers – the husbands, wives, partners and parents, indeed, all of us who ‘live with diabetes’.

IDDT is especially concerned about the needs of people who are unable to use synthetic ‘human’ or analogue insulins because they suffer unacceptable adverse effects and therefore they need pork or beef insulins.

The systematic discontinuation of natural animal insulins in countries around the world means that some people are unable to obtain the animal insulin they need. We believe that we have maintained supplies of beef and pork insulins in the UK for as long as we have because we, the consumers, have fought a battle for the consumers’ right to have an informed choice of insulin species. Also because our insulin market is not entirely controlled and dictated by three major insulin producers – the UK is lucky enough to have a small company dedicated to the production of beef and pork insulins. However, people who need animal insulins are in a very vulnerable position, especially in countries such as the United States where animal insulins are no longer available. This is the reason for the formation of IDDT-US. In 1999 we formed an umbrella organisation, IDDT-International, to address the global threat to the availability of animal insulins for people who need them.

The Trust is run entirely by voluntary donations and we do not accept funding from the pharmaceutical industry in order to remain uninfluenced and independent.
Your news, views, concerns and questions are always welcome. If you would like support or information about diabetes, insulin or IDDT- US, then please contact us.

Contact: Jenny Hirst, Co-Chair:
Jenny Hirst
InDependent Diabetes Trust
PO Box 294
Northampton
NN1 4XS
UK
tel: +44 1604 622837
e-mail: [email protected]
website: www.iddtinternational.org 

Membership of IDDT- US means that you will receive the quarterly Newsletters. IDDT Membership is free, although we do welcome donations to help us to help you.

Your membership will also help us to try to ensure that people with diabetes have a choice of insulins to suit the needs of everyone that requires insulin treatment.

We hope that you will join IDDT – US!

TO JOIN IDDT, CLICK HERE

IDDT United States

Welcome to IDDT – US
Global systematic discontinuation of animal insulins
Personal importation of pork insulin in the US no longer possible

 

Back to IDDT International

Global Systematic discontinuation of animal insulins

There are two major suppliers of animal insulins, the Danish company Novo Nordisk and the American company Eli Lilly have systematically withdrawn their ranges of natural beef and pork insulins from countries around the world. This ‘forces’ people to use ‘human’ or analogue insulins, despite the reported adverse reactions it produces for this significant minority of people who require natural animal insulin to treat their diabetes.

What are the problems that some people experience with ‘human’ insulin?

The most common complaint from people who have problems with ‘human’ insulin is loss or partial loss of warning symptoms of an impending hypo and an increase in the numbers of hypos. This is also confirmed by the information in the leaflet inside packs of ‘human’ insulin. IDDT has received reports from people with diabetes and their families in many countries and the greatest concern for them about ‘human’ insulin is hypo unawareness. Hypoglycaemic unawareness is an unsafe condition that can lead to severe hypoglycaemia resulting in unusual, irrational or violent behaviour, coma and seizures.

A survey carried out by IDDT in the UK showed that the difficulties for this group of people experienced were as follows:

• 41% – loss of warnings of hypos or ‘I seem to function on automatic pilot’.
• 34% – extreme tiredness or lethargy
• 9% – sleeping all the time
• 32% – weight increase of 1.5 stones and above
• 28% – feeling unwell all the time
• 24% – memory loss or confusion
• 9% – blood glucose levels dipping and peaking erratically
• 8% – described by their families as ‘not the same person’
• 5% – mood changes, described as difficult to live with
• 7% – pains, especially ion the legs and joints
• 4% – irregular or late periods

In addition to this 24% 0f those contacting IDDT said that their doctor was unwilling or reluctant to change their insulin to natural animal insulin and 3% told us their doctor didn’t listen or said the problems were ‘all in the mind’.
Other common statements were:

• ‘I didn’t know that there was such a thing as animal insulin.’
• ‘I was never told there were alternatives’.
• ‘I didn’t realise that ‘human’ insulin was not derived from humans’.

Note – These findings confirmed the results of an unpublished study carried out by the British Diabetic Association [now Diabetes UK] looking into the unsolicited letters they received from nearly 3000 people reporting problems with ‘human’ insulin.

IDDT United States

Welcome to IDDT – US
Global systematic discontinuation of animal insulins
Personal Importation of Pork Insulin from the UK
Changing your insulin
Action times of human and animal insulins
Storing of insulin

 

Back to IDDT International

Personal Importation of Pork Insulin from the UK

As animal insulins have been discontinued in the US and beef insulin is no longer being made in the UK , people in the US can access pork insulins they need from the UK by importing for personal use from Wockhardt UK. Importation of drugs for personal use is allowed when a particular drug is not available in the US. Wockhardt pork insulin products are manufactured in a sterile facility designed to specifications of the UK MHRA and the U.S. Food & Drug Administration.

How to import pork insulins
Wockhardt UK has expanded the procedure and the numbers of forms that have to be submitted before people can import pork insulins into the United States. The procedure includes the need for a doctor’s letter and doctor’s prescription.

The details of how to import pork insulins can be found by visiting Wockhardt’s website: www.wockhardt.co.uk

Or you can contact Wockhardt UK as follows:
Wockhardt UK Ltd
Ash Road North
Wrexham Industrial Estate
Wrexham LL13 9UF
UK
tel: +44 1978 661261
fax: +44 1978 660130

Wockhardt insulins have different names from the United States.

The chart below shows the types of insulin available from Wockhardt, the duration of action and the equivalent U.S. name/type where possible:

Hypurin Porcine Neutral [Short]	Regular / R
Hypurin Porcine Isophane [Intermediate]	NPH / N
Hypurin Porcine 30/70 Mix  [Premixed]

The packaging of Hypurin insulins is in braille to help blind and visually impaired people. All the Hypurin insulins are available in 10ml vials and Porcine Neutral, Isophane and 30/70 Mix and bovine Neutral and Isophane are also available in 3.0ml cartridges for use with pen injection devices [AutoPen Classic by Owen Mumford].

Important Point to Remember:

Any change of insulin both type and brand can alter your control especially in the first few days, so you need to monitor more closely.

Pork and beef insulins available in the UK
Synthetic ‘human’ insulin versus natural animal insulin
Animal insulin – Minister’s letter
Limiting availability of blood glucose test strips

 

Back to Here to Help

Pork and beef insulins available in the UK

At the end of December 2007 and for commercial reasons, Novo Nordisk discontinued all their pork insulin products.

Naturally IDDT was angry at this further reduction in choice of insulins for people with diabetes and the total disregard of the needs of the significant minority of people who use pork insulin. However, the good news is that the UK is one of the few countries where there is a second supplier of animal insulins – Wockhardt UK [formerly CP Pharmaceuticals] who supplies both pork and beef insulins in vials and cartridges for pens.

The nearest equivalent pork insulins from Wockhardt UK for people who were Pork Actrapid, Pork Insulatard and Pork Mixtard made by Novo Nordisk are shown on the chart below. We have assurances from both Wockhardt and the Minister of Health that Wockhardt will continue to make supply animal insulins.

Alternative animal insulins available from Wockhardt UK

Discontinued Novo Nordisk insulins	Nearest pork insulin available	Beef insulin available	Vials and pen cartridges
Pork Actrapid	Hypurin Porcine Neutral	Hypurin Bovine Neutral	Yes
Pork Insulatard	Hypurin Porcine Isophane	Hypurin Bovine Isophane	Yes
Pork Mixtard	Hypurin Porcine 30/70 Mix		Yes

As ever, we remind you that with any change of insulin, even if it is just changing brands of pork insulin, you do need to monitor blood glucose levels more carefully during the changeover period.

Note: Supplies of Wockhardt animal insulins

IDDT has always argued that to have one supplier of pork insulin for the whole of the UK, leaves people who need it in a very vulnerable position. This is a matter that we have taken up with the Department of Health and will continue to do so.

If you experience any suspected adverse reactions as a result of a change of insulin, do remember that patients can [and should] report them the Department of Health through the Yellow Card Scheme. Here’s how to do it:

• if you have access to the internet: go to www.yellowcard.gov.uk and CLICK on submit a Yellow Card report.
• if you prefer to use a paper Yellow Card reporting form: many GP surgeries have the cards or they can be obtained from the MHRA, tel. 08008 1003352

Please don’t hesitate to get in touch if we can be of any help.

IDDT campaigning

Pork and beef insulins available in the UK
Synthetic ‘human’ insulin versus natural animal insulin
Animal insulin – Minister’s letter
Limiting availability of blood glucose test strips

 

Back to Here to Help

Animal insulin – Minister’s letter

 

From the Minister of State
The Rt Hon Jane Kennedy MP

Department of Health
Richmond House
79 Whitehall
London
2NS

24.7.05

Jenny Hirst
Insulin Dependent Diabetes Trust
PO Box 294
Northampton
NN1 4XS

Dear Ms Hirst,

Thank you for coming to meet me at Portcullis House on July 11th, to discuss your concerns about the continuing availability of animal insulin.

May I first of all say that the Department of Health fully accepts that some people are better suited to animal insulin, and that animal insulin should continue to be made available. At this time, neither of the two suppliers of animal insulin to the UK has informed us that it intends to stop supply it, although Novo Nordisk says that it will make a decision in 2006.

We have again sought assurances from Wockhardt that it has no plans to discontinue supply of animal insulins. The company says that animal insulins continue to be key products for it. As part of an investment program in its UK sterile manufacturing facilities, production capacities for such products will be significantly enhanced over the next 6 to 12 months. The company says that this investment is essential in order for it to take full advantage of the commercial opportunities that may present themselves, including in the animal insulin market.

Although the market for animal insulin is relatively small, Wockhardt has recently underlined its commitment in this field by seeking registration of its porcine insulin range in Canada. It is expected that Canadian Marketing Authorisations will be in place before the end of the year, which will mean that patients currently being prescribed animal insulin from Eli Lilly, will have an alternative when this is withdrawn from the market early in 2006. Wockhardt has been working closely with Lilly and Health Canada to ensure that there is continuity of supply for patients who wish to continue taking porcine insulins.

As far as adverse effects of human insulin are concerned, it is current clinica practice to start patients on human insulins and there is no clinical evidence that human insulins cause any more adverse reactions than animal insulins. This view  has overwhelming clinical and professional support, and is borne out by the July 2000 Duabetes UK comparative report on all the various animal versus human insulin studies (as the British Diabetic Association).

We have considered whether further (non company) research might be carried out on the adverse effects of human insulin, but given the high demand on R&D budgets for research on subjects of high clinical and policy priority we have concluded that there seems little justification for commissioning research at this time. However you may wish to be aware that there is an ongoing (company-sponsored) study to examine the incidence of serious adverse drug reactions in 4,000 patients receiving the recombinant human insulin insulin analogue determir (brand name Levermir) – the findings from this study will be reviewed by the MHRA.

During our meeting, we discussed how the profile of the issue might be raised, particularly with doctors. As you will be aware, there have been two previous articles on hypoglycaemia unawareness on transferring from animal to human insulin in the MHRA’s drug safety bulletin "Current Problems in Pharmacovigilance", the most recent in September 2000. I have asked officials to make arrangements for another article to appear in the near future. I have also asked them to liaise with National Diabetes Support Team (NSDT) on the possibility of including an article on the Yellow Card Scheme on its next briefing and to discuss with Diabetes UK the possibility of inclusion on their website of a link to www.yellow.gov.uk where patients can report suspected ADRs.

Finally, the MHRA is currently taking forward the recommendations of the Independent Review of Access to the Yellow Card Scheme including patient reporting, access to Yellow Card Data and proposals for increasing awareness of the Scheme.

I hope this is helpful.

Yours sincerely

 

JANE KENNEDY

IDDT Launch Public Awareness Campaign

16th March 2009

The Insulin Dependent Diabetes Trust (IDDT) announced today the launch of their latest public awareness campaign, ‘Understanding Your Diabetes.’ This campaign aims to help the general public have a better understanding of the difference between Type 1 and Type 2 diabetes and help those with diabetes make informed choices about their treatment – not just insulin and medication – but how the right treatment can also improve their quality of life.

The 4 key messages in this campaign are that:

1. Patients should always be involved in decisions about the treatment of their diabetes.
2. They shouldn’t be afraid to ask about their medicines and the available choices.
3. If, or when they move to insulin treatment, then they should know that they can choose between animal, human, or analogue insulins.
4. They should be aware that synthetic human and analogue insulins involve different regimes that often require more frequent daily injections compared with animal insulins. So they need to be able to discuss the choices with their GP to consider how different regimes may affect their lifestyle.

IDDT’s Chair, Jenny Hirst commented; ‘Our members, whether they have Type 1 or Type 2 diabetes, tell us that they need our support and that’s exactly why we set-up IDDT over 15 years ago – to help them manage their condition.’

She continued, ‘People with Type 1 diabetes are tired of being accused – by ill-informed people – that the reason that they have diabetes is because they eat too much sugar, or that they must have been overweight at some stage in their lives. The truth is very different! People with Type 1 diabetes have it through no fault of their own and it is totally unavoidable. In addition, many patients who have Type 2 diabetes also need help to better understand their condition. So we hope that this campaign will help to clarify the differences between the two types of diabetes and help all those who are currently struggling with their management of the disease.’

As part of this awareness campaign the charity has produced a patient information booklet, entitled, ‘Understanding Your Diabetes’ which is available free of charge and explains in detail the differences between Type 1 and Type 2 diabetes.* The booklet is written in plain English and explains the relationship between insulin or medication, diet and exercise. In doing this, it supports people with both types of diabetes by removing some of the harmful myths and misunderstandings. Alongside this booklet the charity will be running a series of advertisements in the medical press and exhibiting at professional conferences to encourage GPs and practice nurses to ‘spread the word’ to their patients.

For further information or copies of the booklet, please contact:

Insulin Dependent Diabetes Trust [IDDT]
PO Box 294
Northampton
NN1 4XS

tel: 01604 622837
e-mail: [email protected]
website: www.iddtinternational.org

* For press enquiries, ‘Understanding Your Diabetes,’ please contact:

Veronica Wray

tel: 020 8568 8546
Mob: 07710 624454
e-mail: [email protected]

IDDT Publications

IDDT provides a wide range of information which has been written to meet the needs of people with diabetes, their carers and health care professionals. This publication list has been compiled so you can order what you need free of charge. Simply state how many copies or items you require, fill in your address in the space provided and submit your order to IDDT.

Free Information

IDDT runs purely on voluntary donations and all the information we produce is free. If you would like to help us continue to provide this valuable information to people with both Type 1 and Type 2 diabetes please send us a donation via Just Giving or Charity Choice.

Healthcare professionals ordering multiple copies

All IDDT booklets and leaflets will remain free of charge. We are delighted that healthcare professionals and others are ordering multiple copies of our booklets and leaflets to give to people with diabetes and grateful for the help and support being given to people with diabetes in this way.

However, IDDT is a charity relying entirely on voluntary donations and due to the large and increasing demand for multiple copies of the booklets and leaflets by healthcare professionals for their patients, it is with regret that we have had to introduce a delivery charge for orders of more than 20 copies in total.

So in future the delivery charges will be as follows.

Number being supplied	20 copies	21 to 50 copies	51 to 100
Delivery charge	FREE 6 monthly	£7.40	£9.40

• For orders over 100 copies, please contact IDDT for the cost of delivery by telephone 01604 622837 or by email [email protected]
• We will supply orders of 20 FREE copies once every 6 months.
• Invoices will be sent with the order.
• If funding the delivery charges is a problem, we are happy to supply FREE multiple copies of Publication Lists for healthcare professionals to give to their patients so that they can order direct from IDDT.

Thank You!

Withdrawal of Mixtard 30

Novo Nordisk plans to withdraw Mixtard 30
Nearest equivalent insulins to Mixtard 30
Humulin M3 injection pens – KwikPen available
IDDT opposes Mixtard 30 withdrawal

  News Release:

Marketing of insulin – a missed opportunity

Novo Nordisk plans to withdraw Mixtard 30

The Herald Scotland [June 9, 2010] published an article stating that Novo Nordisk plan to discontinue human Mixtard 30. Although no formal announcement has been made at the time of writing, in the article Novo Nordisk does not deny that this is their intention as “we continually review our portfolio…. This has resulted in a gradual discontinuation of older animal and human insulins….”

These changes will upset thousands of people who have successfully used this type of insulin for many years and who will be forced to change their insulin not for health reasons but for commercial reasons. We are hear to support you through any changes you have to make, so don’t hesitate to give us a call on 01604 622837.
Link to the Herald Scotland article:
http://www.heraldscotland.com/news/health/nhs-chaos-warning-as-diabetes-drug-axed-in-shake-up-1.1033734

On June 23rd 2010, Novo Nordisk announced the withdrawal of human Mixtard 30 and that this will affect around 90,000 people who will have to change to a different insulin. In its statement, Novo Nordisk said, “Novo Nordisk has provided detailed information and support to health professionals to ensure that patients are moved to an appropriate alternative insulin prior to 31 December 2010. In addition, Novo Nordisk will be working with people running diabetes clinics to assess the impact of this change and provide nurse support where appropriate.”

This withdrawal is not in the best interests of people with diabetes and is a further reduction in the number and types of insulin available to their varying needs. In addition, IDDT is unhappy with many aspects of the withdrawal and opposes the withdrawal Click here for more information

Withdrawal of Mixtard 30

Novo Nordisk plans to withdraw Mixtard 30
Nearest equivalent insulins to Mixtard 30
Humulin M3 injection pens – KwikPen available
IDDT opposes Mixtard 30 withdrawal

  News Release:

Marketing of insulin – a missed opportunity

IDDT opposes withdrawal of Mixtard 30
Actions taken by IDDT against the withdrawal of Mixtard 30

IDDT immediately wrote to the Secretary of State for Health, Health Ministers, Chair of the All Party Diabetes Group, Adrian Sanders MP, the National Clinical Director for Diabetes, Dr Rowan Hillson and various other interested people. We requested that if they could not persuade Novo Nordisk to continue to supply Mixtard 30, that they at least put the following measures in place:

1. That Novo Nordisk gives at least 18 months of notice of withdrawal as many people with diabetes only attend a clinic 12 monthly. This will also help diabetes clinics to cope with the extra workload involved.
2. That patient safety must not be compromised. Although Novo Nordisk may consider the analogue, NovoMix 30, to be a superior product, there is no independent evidence to show this and it may not be suitable for some people. So patients must be informed of the nearest equivalent insulins from other companies, such as Humulin M3 by Eli Lilly.
3. It is imperative that patients are reassured that they will be offered an independent and informed choice of insulins, including those of other manufacturers. Therefore if there are nursing staff shortages due to the pressure of numbers of people needing appointments, any ‘additional’ nurses should be sourced and trained by the NHS and not by Novo Nordisk.

In view of the restrictions which many GPs place on the number of blood glucose test strips that people with insulin-requiring diabetes receive, it is essential for the safety of patients that there are no restrictions are placed on the numbers of blood glucose strips prescribed during and after the changeover period.

IDDT is doing what it can to try to ensure that Mixtard 30 and a wide range of insulins remain available to suit all needs. In the meantime, if we can help you, support you or provide information on the choices of insulin that are available, then please do call us on 01604 622837 or e-mail [email protected].

Withdrawal of Mixtard 30

Novo Nordisk plans to withdraw Mixtard 30
Nearest equivalent insulins to Mixtard 30
Humulin M3 injection pens – KwikPen available
IDDT opposes Mixtard 30 withdrawal

  News Release:

Marketing of insulin – a missed opportunity

Nearest equivalent insulin to Mixtard 30

Mixtard 30 is human premixed insulin 30% of which is short-acting insulin and 70% is intermediate-acting, isophane insulin.

Humulin M3 is the nearest equivalent insulin to Mixtard 30. It is made by Eli Lilly and is also human premixed insulin made up of 30% short-acting insulin and 70% intermediate-acting, isophane insulin.

The only pre-mixed insulin that will be available from Novo Nordisk is NovoMix 30, an analogue premixed insulin 30% of rapid-acting NovoRapid [aspart] insulin and 70% protamine insulin aspart. This is not the same, nor even similar as NovoMix 30 has a very different peak and duration of action to Mixtard 30, as the chart below clearly demonstrates. The chart also demonstrates that Humulin M3 is more similar to Mixtard 30 than NovoMix 30.

So if you are forced to change from Mixtard 30, then the nearest equivalent insulin is Humulin M3. Clearly, Novo Nordisk will want people to stay with their brand of insulin, in this case NovoMix 30, and you may be advised to do this but remember, this is not the same. IDDT’s advice is to discuss your options with your diabetes team and if you want the nearest equivalent insulin, then ask to change to Humulin M3 and not NovoMix 30. 

Duration of the peak of action of premixed insulins

	Hour	0	1	2	4	6	8	10	12	14	16	18	20	22	24
Mixtard 30	human
Humulin M3	human
Pork 30/70	pork
NovoMix 30	human

 

Information drawn from MIMS, June 2010

GlucoGen Stocks Low

European stocks of GlucoGen injections have been limited due to a manufacturing problem which has now been resolved but it will take a few months for Novo Nordisk to replenish their stocks.
Manufacturers Novo Nordisk say that the shortage is unlikely to affect people with diabetes directly as the company does have stock in its UK warehouse.

There are no quality or safety problems with the GlucGen products already in the supply chain.

However, as a precaution, Novo Nordisk is limiting supply to wholesalers to prevent reducing stocks too far. Stock will not be sold to wholesalers but kept in reserve to supply against patient prescriptions should the need arise. If pharmacists do require a direct order service because their wholesaler cannot supply, then they should contact Novo Nordisk directly on their customer Careline – 0845 600 5055.