Biosimilar insulins and how things changes. Horror.

I think the diabetic community is too quick to panic. The online community tends to be filled with diabetics being very strict about everything they do and clinical about every aspect of their care. There is nothing wrong with that of course but I think often it is forgotten that the famed ‘doc’ is the minority. I fall into the middle ground. I tweet and I blog and I care but I don’t have the same goals many others do. I don’t dream of HBA1cs under 6 and I certainly did not want a pump until it was the only option available for me to have a close to type zero life. If I did not have my dawn phenomenon I would swap my pump for injections in a heartbeat.

Pumping is stressful. Every three days you stare DKA in the face. The set change may work and it may not. It may take many hours to spiral out of control and it may take only a couple. The spiral may be masked by things you ate before the change, glucose levels before the change, things you need to do right after the change. Every level that doesn’t look perfect after a set change makes me fear the set did not work.. But if it did and I change it, the next one might not work. What if they both don’t work? What if I’m so anxious about blood sugar levels that I’m screwing up my own life?

Sadly, these thoughts are common.

Sets fail. They come off production lines and then they rely on being in the exact right place when the button is pressed. They screw up. Life is not perfect.

People seem to forget that. It is I WANT THIS and I WANT THAT and in Britain certainly only their national insurance to pay for it? Technology costs money. My blood kit is old. Ancient really. I have had it a whole …well five years at least. No…not the same type, the same machine…People seem to swap kits like socks these days and expect doctors to get their prescriptions changed in jig time too. Thing is…those things take time. Letters and emails get into queues and piles. Your demand for a different type of test strip might be sitting under a report on how effective cancer treatment is and on top of a set of blood tests for a high risk pregnancy while someone else needs a referral to X Y or Z clinic. Add that to the GP that is sick that week and the fact that normally they could use another anyway and they have patients to see and prescriptions to approve and yeah, sometimes it takes longer to get that new kit up and running. That is why pump clinics try get the new insulin on the script early and pump starts begin with a year of supplies before they even get near the machine.

Diabetics that have had this disease for decades are still alive. I’m pretty sure we can survive on certain glucose machines for a few months and be grateful we have them at all while we are at it. The NHS was meant to do it all. Body. Eyes. Feet. Teeth. That fell apart very quickly. It does not have to give you everything that you want the instant that you want it. That is what Bupa exists for. The Western World forgets how privileged it is. The thing is, a lot of modern tech is there to make things easier. It does not exist to magically make things possible. We can test and record on any meter. Many meters are just as accurate as the ones that record everything under the sun and talk to your computer to write out spreadsheets about it. People want a disability to be convenient and the fact is we are disabled, we’re always gonna be, and that is not convenient.

Treatments change. Often. A lot. Diabetics think that means insulins and such. It doesn’t. Our treatments also include the way Doctors try to help us control our disease, the insulin we use to do that which includes the doses and types and times we take them. Treatment changes mean whether taking lantus in the morning or at night, in one dose or two, or whether we give it up all together for a shorter acting long acting like insulartard.

As usual it seems diabetics are going to panic before looking more deeply into what they are being offered. Biosimilar insulins. It sounds scary but then so did ‘cloned’ insulin when I started that sort of stuff. It turned out to be humulin and such and greatly improved my life. My outlook on diabetes is if it has made it as far as my hospital then it is worth at least trying it. Pharmacists and such are not idiots. Neither are the people who approve things for the NHS though sometimes it seems so. The times they appear in the press are a fraction of the time. Even the ‘cheapest’ insulins are big money because so many people are diabetic and the number only skyrockets, especially with more type twos now being treated with insulin. We’re not being shafted.

Think back to the insulins YOU had to take when first diagnosed. Are they the ones you take now? Were they even all available then? Did you count carbs the same? Did you count them at all? Did you get to choose when to eat or did someone in an office decide that for you?

Things change. Insulins change. Kits change. Ideas change.

We cannot judge these biosimilar insulins until people in the UK are trying them and believe me there will be volunteers. For every D comfortable with their current insulin there are several ripping their hair out and wondering why it Just. Wont. Work. Because it works for everyone else right? Sure they say it will be cheaper but nothing suggests so far that it will not be as effective.

Does where the money goes really matter? We will only take this insulin if the savings go to US. That sounds a rather bitter way to think about it really. Any savings the NHS can make benefits us all in the long run as long as the people who are running it happen to have a conscious. Sure I would love any savings to come to us but really I just hope there are savings.

The thing I see not being addressed is the reason for these insulins. Patents. They are going to run out. So the insulins we have are not safe and they will not stay, not as they remain now. Not as far as things suggest now. Change is coming. We can either embrace it and engage with it and work out how best to make it work or we can ….get ourselves in a right faff.

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