Mixtard 30® Withdrawal
EDP column by Dr Ketan Dhatariya

“I have heard that the insulin I am using for my diabetes is being withdrawn. I have been on it for over 10 years and do not want to change. What should I do?"

You are correct, a particular brand of insulin, Mixtard 30®, is being withdrawn in the UK from the 31st of December 2010.

Insulin was first discovered in 1921 in Canada and was an instant success. It has saved countless millions of lives since then. As you may be aware, there are different forms of insulin. The old insulins were made from animals, in particular beef and pork. These had problems associated with them because they sometimes caused people to become allergic to them. However, there are still a few people about who have used them safely for decades and continue to use them with no problems. In the 1980’s the next generation of insulins were launched. These were the insulins that were identical to that made by the pancreas in humans. Whilst these insulins were safe and did not cause allergies or other problems, they were given in a way that insulin was not designed to be given. Let me explain, insulin is normally produced by the pancreas and when it goes into the blood stream it goes directly to where it is needed the most – in the liver. However, when insulin is given to people with diabetes, it goes into the skin and only by a long trip around the blood stream does it get to the liver. By injecting insulin into the skin, it affected the absorption of the insulin.

The next generation of insulins that were launched in the early 2000’s tried to overcome these issues. Whilst they are still injected into the skin, they are designed to be absorbed faster and reach the liver quicker. However, as with all new medicines, the newer drugs cost more than the older, more established drugs. Many more people who are on insulin now use the newer drugs, rather than the older, human insulins.

The company that makes the insulin that is being withdrawn is doing so for reasons that anyone who runs a company will be familiar with. When the sales of a particular product starts to fall, then it may no longer be economically worth while to keep producing it. That is what has happened with Mixtard 30®.

Do not worry, there are suitable alternatives. Your doctor or pharmacist will be able to help you. The change that they are likely to suggest for you is to stay on a very similar human insulin called Humulin M3®, The only difference is the injection device. If you have difficulty with the injection device and want to stay with the one that Mixtard 30® uses, then your doctor may suggest you go onto the new insulins.