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How do they decide on which Insulin?

M

Mervyn

Well-Known Member
Messages
149
Hi,
I was wondering on the decision making process in deciding on the Insulin mix that we are prescribed?

For instance I am on Humalin M3,after starting on Lantus. A chap up the road is on Novamix and my local newsagent is on another mix. I have not asked my DNS as she is very busy and I only talk to her twice a week on her mobile phone, and perhaps it is a question that she may feel is unimportant.

The only indication that she has given,in a passing comment, is that she thinks Humalin M3 works better than say Novamix.
So is it down to the DNS preferences for a different manafacturer? or, as I would hope, is it more considered than that?

Thanks
Mervyn
 
I asked this question to my diabetes nurse recently. Her reply was that a range of insulins are permitted by the local PCT but within that range the insulin is generally chosen and prescribed by the consultant in charge of your diabetes. In my area the decision is based on cost. When a company rep offers a good price they get the order for that period of time. Occasionally a patient may have an intolerance to certain types of insulin, but generally cost is the key factor in their choice.
 
The type of insulin used should be based on clinical need and suitability for the patient as an individual. There are guidlines produced by NICE to support health professionals with their decision. In some instances the ability to use a particular device eg easy to use pen/innolet determines the brand of insulin. If you need to have a relative, carer or district nurse visit to give the insulin, that is also a consideration. People with type 2 who have progressed to insulin are often started on a once a day basal insulin and this may be enough, along with tablets to give reasonable control. Some people need to go straight on to a twice daily mixed insulin, espacially if their post meal readings tend to be high. Humulin M3 is a 30/70 mix that often suits those with Type 2. Novomix is an analogue insulin, the quick acting part has a much more rapd onset then the quick acting poertion of a human insulin like M3. It often works better for Type 1 than type 2. idealy the person prescribing will be able to look at your blood glucose diary to help their decision about the type/mix/frequency of insulin needed. The most expensive insulin is the one that is used inappropriately or not at all
 
I am on Humalog 25 and this was chosen because of my sensitivity to other diabetic drugs. It was felt that it would suit me better. Partner is on Novamix 30..

Prescribed by two different diabetic nurses based on our records and reactions to other meds.
 
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