Diabetes patients forced to ration insulin due to product shortage

Diabetes patients are having to ration their use of insulin due to a shortage of one of the most commonly used products in Ireland.

Some are adjusting their diet by eating fewer carbs to make their insulin last longer, according to patients.

The shortage of Fiasp vials of insulin is just the latest medicine scarcity to hit the Irish market. Almost 300 commonly used drugs, including cough mixtures, statins and antibiotics, are in short supply, according to the Health Products Regulatory Authority (HPRA).

Patient concern

Novo Nordisk, which manufactures Fiasp, has warned of potential shortages of its other insulin products if patients unable to access Fiasp switch to them.

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Sinn Féin health spokesman David Cullinane has received “a lot” of messages from diabetes patients concerned about continuity of insulin supply, he says.

“Some are telling us that they have their supply but are concerned about future access, others are saying their pharmacist does not have the alternatives in stock.”

Dee Ferry, from Co Donegal, says she had experienced difficulty obtaining insulin for her son, who has Type 1 diabetes, over the past two months.

“It’s a bit worrying that we’ve got to the stage where we have to ration a drug that is a matter of life and death for some patients. This is not something you can swap with another medicine. The pharmacist is at the end of their tether trying to get it. They’ve rung everywhere, with little success.”

Her son needs three vials a month, but can only get one. “There are people who need six vials a month, but cannot get what they need,” Ms Ferry said.

While some patients have been given another insulin drug, Novorapid, this is now in short supply due to a “ripple effect”, she says.

Some people with diabetes have changed their diet, by reducing their carb intake, in an effort to make their available insulin supplies last longer, according to Ms Ferry.

Missing insulin treatment can lead to life-threatening diabetic ketoacidosis, in which the bloodstream becomes acidic and the patient severely dehydrated.

Although Novo Nordisk says the supply shortage will be resolved by the end of this month, Ms Ferry believes her son, and others, “won’t last a month without their regular supply of insulin”.

Manufacturer Novo Nordisk last month warned of a shortage of Fiasp insulin vials, which it said was due to manufacturing delays.

Switching medicine

While it advised pharmacists to switch to alternative insulin supplies, it said this has to happen under strict medical supervision and patients need to have their glucose closely monitored in the weeks after the switch.

It asked pharmacists not to switch from Fiasp vials to other company products “as increased demand may result in shortage of these presentations”.

The HPRA says it is continuing to engage with Novo Nordisk about the shortage of Fiasp vials.

A spokeswoman told The Irish Times there are 150 insulin-containing medicines authorised in Ireland and Fiasp is “the only one notified as in short supply”.

Kathy Maher, a pharmacist in Duleek, Co Meath, says she only has Fiasp pre-filled pens at present “and all the range is out of stock as far as I can see”.

While patients can be switched to other products, this has to be done “with caution. Most would need to go back to their diabetes team and have it done under supervision. However, Fiasp vials are often used with an insulin pump so it’s quite specialised.”