# Designer insulin! BBC news story



## Natalie123 (Sep 22, 2011)

Just thought I should post this link so others can see what they think of it. 

It worried me that people who know so little about diabetes can say that analogue insulins are too expensive, if they had diabetes they would want the best treatment for them regardless of cost. I can see what they mean, that human insulins can be appropriate for many and should be tried first, but I am worried that it might become more difficult to switch to analogue insulin if, like me the person doesn't get on with human insulin.

Here's the link: http://www.bbc.co.uk/news/health-14999853


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## Caroline (Sep 22, 2011)

I think it is down to money again. So many effective treatments are put on the back burner because they are seen as too expensive. Keep everyone ft and healthy withthe proper treatment and we are more productive and effective in all kinds of ways.


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## Robster65 (Sep 22, 2011)

I saw it on twitter when Everydayupsanddowns retweeted it with suitable anger.

I've had a good rant about it there. I suspect it's just someone who thinks they've had a good idea and wants to shout about it. Hopefully, the purse strings are held by someone with an ounce of common sense.

There are always cheaper alternatives to any illness. But effectiveness and long term prognosis is taken into account. They ignore those factors.

I can remember, like many, how rubbish the fixed profile insulins were. No quality of life compared to analogues. I for one wouldn't wish anyone to go back to that.

Rob


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## Pumper_Sue (Sep 22, 2011)

Having just skimmed through the news item, this is not new news so to speak.
It has been proved countless times that there is no benefit from using analogues except to line the pocket of the drug companies.

Interesting though there is no mention of animal insulin in this latest report.
Yet it is freely available and has kept me well for almost 50 years on insulin, oh and is cheaper as well.
Obviously though with all things some people can not use one or the other so this needs to be addressed.

This made me laugh


> Simon O'Neill, Director of Care, Information and Advocacy at Diabetes UK, said insulin analogues should be as available to all people with diabetes.
> 
> He said: "The decision of which insulin is the most appropriate for a person with diabetes should be made on an individual basis in consultation with the person with diabetes themselves."



How many people when newly diagnosed would be able to have an informed choice of insulin? How many people were actually asked?
Infact how many hospital staff know anything about older insulin's?


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## FM001 (Sep 22, 2011)

Having experienced animal and human insulins previously I can honestly say that the benefits of analogue insulin far outweigh any extra costs that the nhs incur, I could never achieve what I would call good control until I made the switch to analogues.


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## Pumper_Sue (Sep 22, 2011)

toby said:


> Having experienced animal and human insulins previously I can honestly say that the benefits of analogue insulin far outweigh any extra costs that the nhs incur, I could never achieve what I would call good control until I made the switch to analogues.



When you tried them did you have the benefit of blood testing? Depending when you were diagnosed most things would be hit and miss pre 1982 or there abouts when home testing first came in.


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## Copepod (Sep 22, 2011)

There are plenty of older chaper insulins, which for some, perhaps even many, people are just as effective.
Eg I've been using Humalin I since diagnosis, and it's considerably cheaper (5 x3ml cartridges cost ?19.08) than the analogue alternatives, Levemir (?41.50 for 5 x 3ml cartridges) and Lantus  (?42.00 for 5 x 3ml cartridges) All prices from BNF 62, Sept 2011.

I can't see the problem with trying a cheaper insulin first, and moving onto more expensive only if the cheaper isn't suitable.

This report is not comparing the costs between basal bolus / MDI regimes and the old style bimodal insulins, which I agree are unsuitable for many people, although not all.


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## FM001 (Sep 22, 2011)

Pumper_Sue said:


> When you tried them did you have the benefit of blood testing? Depending when you were diagnosed most things would be hit and miss pre 1982 or there abouts when home testing first came in.




Just forget what year it was when I bought my first blood glucose meter but I'm certain I was still injecting animal insulin, definitely had one when I switched to human so can back up what I have said but only from memory


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## trophywench (Sep 22, 2011)

Well like most things Sue, of course we'd consider em if we couldn't have what we have!  But if it works well, why would any of us want to consider  change in the first place?

But some of us have had bad experiences with some of those things.  And we wouldn't have the same flexibility as we do now.  Potentially, neither would you or me, because if they can't afford the insulin then they can't afford pumps, can they?  And then test strips ......

And we'd all sit here moaning that everyone in the rest of Europe and elsewhere is allowed to have whatever it is, and be able to have better lives and we are not ...... 

Wouldn't we?


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## Robster65 (Sep 22, 2011)

trophywench said:


> Well like most things Sue, of course we'd consider em if we couldn't have what we have! But if it works well, why would any of us want to consider change in the first place?
> 
> But some of us have had bad experiences with some of those things. And we wouldn't have the same flexibility as we do now. Potentially, neither would you or me, because if they can't afford the insulin then they can't afford pumps, can they? And then test strips ......
> 
> ...


 
I would 

I think that's the point. The pharmas develop newer and better meds for profit. We crave them for improved health or flexibility. If they don't offer that then no point in having them. Most of us don't get offered a choice of the best or a cheaper alternative. I would imagine it depends which rep has offered the better free toy to the GP/DSN that week.

Rob


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## Robster65 (Sep 22, 2011)

Just remembered, I was on insulatard before lantus. And actrapid ( i think)before humalog. Oh, happy days.

Rob


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## Monica (Sep 22, 2011)

Pumper_Sue said:


> How many people when newly diagnosed would be able to have an informed choice of insulin? How many people were actually asked?
> Infact how many hospital staff know anything about older insulin's?



When you're newly diagnosed, you have to learn so many things. Do you really want to go and find out for yourself which insulins are available? We were told that Mixtard would be the insulin Carol has to use. 
Did we know there were other insulins available? No.

Did we know there was another way of managing your diabetes (MDI or pumps)? No. 

Did we even know that you could inject with a pen instead of syringes? No.

All those things we learnt about as time went on.

Our hospital does know about other insulins, and they will prescribe it if the patient asks them to, but their standard seems to be Novomix(in Carol's case Mixtard) first and then, if going on MDI, Novorapid and Levemir. And in the pump Novorapid.

My friend's daughter went from Mixtard to Novomix. But she didn't get on with Novomix, so she went back to Mixtard. When Mixtard got withdrawn, she was put on Humulin3, as that one was the closest to Mixtard (it was my friend's choice not to go on MDI). The girl's dad is also on Humulin3, because he used to be on a pork insulin mix (don't know the name) which was withdrawn not so long ago.

The choice is there, but as a newly diagnosed you don't know that. You just go with what the consultant decides.

I'm not impressed with the word "Designer". Yes it is designed insulin, but "Designer" seems to stand for expensive and unnecessary, which it is NOT.


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## Catwoman76 (Sep 22, 2011)

Robster65 said:


> Just remembered, I was on insulatard before lantus. And actrapid ( i think)before humalog. Oh, happy days.
> 
> Rob



Yes Rob I was on Actrapid and then had to stop ( not my choice) then my Insultard was changed last year to Levevmir because of the Carb counting course I started.  I wasn't told much at all and noone said (well they wouldn't would they) how much more it costs.
 It is annoying to read that article and even MORE annoying is the dimwits that use the inappropiate word 'designer' oh dear  Sheena


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## Northerner (Sep 22, 2011)

Catwoman76 said:


> Yes Rob I was on Actrapid and then had to stop ( not my choice) then my Insultard was changed last year to Levevmir because of the Carb counting course I started.  I wasn't told much at all and noone said (well they wouldn't would they) how much more it costs.
> It is annoying to read that article and even MORE annoying is the dimwits that use the inappropiate word 'designer' oh dear  Sheena



Totally agree - not only do we have a 'lifestyle' disease, we also demand the 'designer' accoutrements to go with it! Anyway, it's not just insulin - many doctors prescribe branded drugs when generics are available at a much lower cost (this happened to me with ramipril - prescribed branded by one doctor which another doctor changed to generic when I needed an increased dose). There's nothing wrong with the suggestion that many people may be just as well off on the cheaper insulins - remember that there are nearly 1 million Type 2s on insulin which may be just a long acting with less complexity in treatment. The problem is the way it is reported. Diabetes can be an horrific disease to contemplate and this article simply tries to make us feel guilty for receiving the most suitable treatment by implying that we ALL could be just as well off on the cheaper stuff


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## AJLang (Sep 22, 2011)

toby said:


> Having experienced animal and human insulins previously I can honestly say that the benefits of analogue insulin far outweigh any extra costs that the nhs incur, I could never achieve what I would call good control until I made the switch to analogues.



I completely agree.  Since changing from animal insulin I have never had a hypo that I couldn't deal with myself prior to that I would collapse with no symptoms  On human insulin my BG always started increasing from mid-afternoon onwards and there was nothing that I could do about it apart from injecting extra short acting insulin. My HBA1cs were much better once I went onto split dose levemir (and this was all many, many years before the gastroparesis problems)


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## AJLang (Sep 22, 2011)

toby said:


> Just forget what year it was when I bought my first blood glucose meter but I'm certain I was still injecting animal insulin, definitely had one when I switched to human so can back up what I have said but only from memory



I had my first testing machine when I was 13 or 14 - so nearly 30 years ago so I was definitely still on animal insulin


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## Pumper_Sue (Sep 22, 2011)

> The girl's dad is also on Humulin3, because he used to be on a pork insulin mix (don't know the name) which was withdrawn not so long ago.



Hi Monica,
the pork insulin has not been withdrawn. Someone has been told some porky pies to get him to change over by the sound of it 
http://www.wockhardt.co.uk/products/searchresults.asp?Keyword=&Therapy=24&Country=112


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## sofaraway (Sep 22, 2011)

I'm someone who has gone the other way, switched from lantus to humalin I, It's not perfect but until I go onto the pump it works much better. I wish I could have changed a long time ago. I wouldn't chose to use human insulin in place of novorapid (or another rapid acting analogue) as I need the quick onset of action.


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## Twitchy (Sep 22, 2011)

As far back as I remember (I was diagnosed at 11 months!), I was on Humulin Isophane & Humulin Soluble (can't guarantee the spellings!!). I look back at my HbA1cs & frankly shudder, they were about as good as they could be on 2 jabs a day, with a growing body & child's chaotic lifestyle, but rubbish compared to what we could / should achieve now with at least MDI or ideally a pump.  One side effect of these 'wonderful cheap'  insulins was hyperlipotrophy (if that's how you spell it?!) - I have a photo of myself aged around 5 in ballet kit (don't laugh please!) and my injection sites were marked by *huge* swellings...in fact by my late teens the effect of this meant I could only wear wide leg trousers & my insulin action was so hit & miss I had to have liposuction to remove the damaged tissue & get some injection sites back!! Flipping painful (C section hurt less afterwards that this!) and I daresay cost the nhs quite a bit too... I wonder would that really have been cheaper than more modern insulins without those side effects?

In the end they switched me to a different insulin solely because I had developed an allergic reaction to presumably one of the preservatives in those insulins - I used to get a sore (insect sting like) itchy red blotch every time I injected. 

I don't think I have particularly brittle diabetes, but the only regime that has ever effectively, consistently & reliably resulted in good control without nasty side effects or huge weight gain (eg eating 'up' to the insulin dose as couldn't get useful increments out of mdi) has been a pump, with Humalog lispro. Maybe someone being diagnosed now at the same age I was (ie 11 months) who got more or less straight onto a pump, wouldn't be having had loads of treatment also for diabetic retinopathy by their early thirties, impacting their ability to work / pay taxes... I just don't think those a******** at 'nice' get that part of the equation. 

Final point - I am sick & tired of this media witch hunt against diabetics...they wouldn't dare suggest that "smokers cost the nhs a fortune in cancer drugs"  (to use similar language to their article on diabetics) even if there might be elements of truth in that, or "Motor cyclists cost the emergency services a fortune by having more accidents" (1% road users, 23% accidents round here for example, so it is technically a fact!).  I just don't see why the media feels diabetics are a fair target for this kind of harassment. I have complained to the BBC (don't think for a second they will bother to respond), but it hacks me off...  Right, off soap box...


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## trophywench (Sep 22, 2011)

They won't have a witch-hunt against bikers it's a fact.  They call us 'organ donors'.  Fact.


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## Northerner (Sep 22, 2011)

You're on good form Twitchy!  In any case, as has been stated elsewhere, it's not the people with diabetes who are demanding these expensive treatments, the overwhelming majority will have no input whatsoever to the type of insulin they are given, so why attack us?

In another report on the same story I read the following:



> But, he added that the cost effectiveness of synthetic insulin depended on the type of diabetes, the individual patient and the type of synthetic insulin used.
> 
> He said: ‘For example, rapid-acting insulin analogues in patients with type 1 diabetes are likely to be a cost-effective use of finite healthcare resources.'


 (from Pulse)


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## Catwoman76 (Sep 23, 2011)

Northerner said:


> Totally agree - not only do we have a 'lifestyle' disease, we also demand the 'designer' accoutrements to go with it! Anyway, it's not just insulin - many doctors prescribe branded drugs when generics are available at a much lower cost (this happened to me with ramipril - prescribed branded by one doctor which another doctor changed to generic when I needed an increased dose). There's nothing wrong with the suggestion that many people may be just as well off on the cheaper insulins - remember that there are nearly 1 million Type 2s on insulin which may be just a long acting with less complexity in treatment. The problem is the way it is reported. Diabetes can be an horrific disease to contemplate and this article simply tries to make us feel guilty for receiving the most suitable treatment by implying that we ALL could be just as well off on the cheaper stuff



My liittle grandaughter Grace has a lot of 'NHS money' spent on her since being diagnosed.  I would of just liked some of these dimwits( a word I used earlier) to have seen my Grace in The HDU on June 1/2/3 etc, with tubes and lines coming out of her and an oxygen mask on. It was a shocking sight. What would these people have said then? That's the real world, not pathetic blaming/cost stories in the media.  Off my soap box now.  Best wishes Sheena


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## trophywench (Sep 23, 2011)

I've had a day or two to think about this - and of course - calm down dear.

Looking at the original Paper my belief is this was really supposed to highlight to HCP's that 'newer' doesn't always mean 'better' and if there was no other compelling reason to prescribe the latest whatever, then why do it.  Try the older cheaper stuff first and if that doesn't work for the patient for whatever reason, then back to the drawing board.

Which actually is absolutely fair enough in my book.

However, the news media have distorted it and as per usual, have picked on the bits of it that suit their purpose.

On my other forum someone (in Scotland) has pointed out that last week the BBC were saying how scandalous the lack of pumps was - and now they are saying we cost far too much anyway and infer we should all be consigned to the lowest cost drug.  Utterly potty.


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## Robster65 (Sep 23, 2011)

The BBC do seem have gone very 'tabloid' recently. Unless they always were and I missed the stories.

Maybe the NOTW hacks have been re-employed by them ? 

Rob


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## Twitchy (Sep 23, 2011)

trophywench said:


> However, the news media have distorted it and as per usual, have picked on the bits of it that suit their purpose.
> 
> On my other forum someone (in Scotland) has pointed out that last week the BBC were saying how scandalous the lack of pumps was - and now they are saying we cost far too much anyway and infer we should all be consigned to the lowest cost drug.  Utterly potty.



I agree - I have no beef with docs using cheaper treatments, IF & only if they are effective - it's the media I'm fuming at! We don't need vilifying on top of everything else we have to deal with!


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## Donald (Sep 23, 2011)

This was in a E-Mail I got this morning

http://glycosmedia.us2.list-manage....7ace9a95614e54b964&id=4793419def&e=7cfcc5a9fc


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## everydayupsanddowns (Sep 28, 2011)

That's odd Donald... looks like it's a duplicate of this one: 
http://bmjopen.bmj.com/content/1/2/e000258.full?sid=c7af650f-180d-461f-bbd4-42966be84978

Which has some comments added to it.


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## Donald (Sep 28, 2011)

they seem the same just different comments at end


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