Those prescribed the insulin Mixtard 30 in the UK have until 31st December 2010 to change their treatment before the medication is withdrawn by manufacturer Novo Nordisk.
People taking the medication are urged not to panic though because there are several alternatives available and people should consult their GP or diabetes healthcare professional to discuss other options.
Diabetes healthcare professionals have voiced their concerns over the decision. The Association of British Clinical Diabetologists (ABCD) warned that 90,000 people in the UK with diabetes would be affected by the plans to stop manufacture of Mixtard 30.
Dr Susannah Rowles, a consultant in diabetes, endocrinology and general medicine at the Pennine Acute Hospitals NHS Trust based in Bury, Lancashire, said patients' health may be at risk if the complex transition between old and new forms of insulin was not well managed.
Dr Rowles said, ‘Mixtard 30 is a type of insulin that has allowed many people to control their diabetes. Withdrawal of the product will undoubtedly cause concern to patients, their carers and health care professionals and we are determined to do whatever we can to minimise this anxiety.'
‘ABCD's overriding concern is that patients and their carers are given timely and proper advice from professionals experienced in the use of different insulin regimens, and who are experienced in the challenges involved when switching between different types of insulin, and insulin delivery devices.’
The symptoms of hypoglycaemia when changing from one different form of insulin to another may be different, or even absent, for some individuals. Dr Rowles states that it is very important that people are counselled and educated about the treatment of hypoglycaemia, and dose adjustments are discussed, by those who specialise in diabetes care.
ABCD said the device by which insulin is delivered is also of vital importance to people with diabetes. For those with limited dexterity or poor memory, factors more common in the elderly population, Mixtard 30 can be administered by a tailor-made device. Other pre-mixed insulin cannot be administered via this device, which for some, is the only way they are able to continue to administer their own insulin.
As Mixtard 30 is a pre-mixed combination of short-acting and intermediate-acting insulin, its administration is twice daily. For those individuals requiring assistance with their injections from carers or district nurses, this means that only twice daily contact is necessary. Some alternative insulin regimes may require more frequent injections.
Gwen Hall, DSN/Clinical Practice Educator and member of the DRWF Editorial Advisory Board, agrees with the ABCD and points out that with 90,000 people to educate and support in only six months this is going to add to the workload at a time when nurses are being asked to work with limited resources.
She said, 'Mixtard 30 is a ‘human’ insulin (mimics natural human insulin) and is designed to be taken 20-30 minutes before food. If a change to an ‘analogue’ insulin, such as NovoMix 30 and Humalog Mix 25 is considered, they can be taken just before eating. In many cases this will involve learning how to use a new pen injector. Don’t leave it until the last minute, get in touch with your diabetes team now if you are using Mixtard 30'.