Imagine an insulin regimen that you relied on was suddenly taken off the market. For Allison Smart, and thousands of other caregivers and people with diabetes, that scenario is becoming a reality.

Smart is a founding member of the Alliance to Protect Insulin Choice, an advocacy group working to raise awareness about the discontinuation of Levemir, a long-acting insulin used by people with type 1 and type 2 diabetes. Her daughter is among the people who have relied on Levemir to manage her diabetes, and switching to another insulin hasn't provided the same flexibility or glucose control.

Levemir, also known by its generic name insulin detemir, is different from other long-acting insulins because many people use it in multiple doses throughout the day. For Smart's daughter, that flexibility has made it easier to adjust her insulin around her cycles, competitive tennis schedule, and other changes in daily life. After trying other long-acting insulins and even an insulin pump, Levemir remained the option that worked best for her.

As insulin manufacturers shift their focus toward other products, including GLP-1 medications, some insulin options are disappearing from the market. While biosimilar versions of other long-acting and rapid-acting insulins are being developed, Smart says there is currently no clear replacement pathway for detemir.

Over the past several years, Smart and other advocates associated with the Alliance to Protect Insulin Choice have met with congressional offices, the FDA, the Department of Health and Human Services, physicians, manufacturers, and pharmaceutical distributors to explore possible pathways to bring detemir back to the U.S. market. One potential option could involve using a drug shortage pathway to allow an outsourcing facility to manufacture the insulin, while another could involve assistance from Novo Nordisk supplying ingredients needed for production.

In the second installment of our Diabetes Advocates series, Allison shares how a personal concern turned into a national advocacy effort, and why preserving choice in diabetes care matters. Her message is simple: not every person with diabetes responds to treatment options in the same way, and losing access to a medication can have consequences that aren't always visible to the people making those decisions.

For the full story, check out the video above. To learn more about these advocacy efforts, share a statement, or make a donation, visit the Alliance to Protect Insulin Choice’s website.

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