Recognizing the Urgency to proactively plan a switch: Managing Timely Insulin Transitions for Continuity of Care

The Urgency to proactively plan a switch: A Proactive Approach to Managing Insulin Discontinuation

The withdrawal and discontinuation of insulin products from the market can notably disrupt established treatment plans, potentially causing stress in people with diabetes using insulin and healthcare professionals (HCPs).^1,2 Despite advance notice of discontinuation, many patients continue using insulins that will soon be unavailable, and new patients are still initiated on them.² This creates an urgent need for HCPs to develop effective strategies for managing these transitions.¹

This article highlights the importance of proactive insulin transition planning and offers practical guidance to help HCPs manage these changes while maintaining quality care.

The Impact of Insulin Discontinuation

The discontinuation of insulin products presents unique challenges in diabetes management. Different insulin formulations often require different dosing regimens, necessitating careful titration and monitoring when switching between products.¹ For insulin products not available in a disposable pen/device, HCPs may need to educate patients on how to load cartridges into reusable pen devices, adding another layer of complexity to the transition process.¹

Additionally, issues of access and affordability may complicate transitions. Patients may face barriers when switching to alternative insulins, including insurance coverage limitations, higher out-of-pocket costs, or availability constraints.^3,4 These challenges underscore the importance of proactive planning and communication when insulin discontinuations occur.

Despite early announcements, many providers postpone transition planning, assuming that existing stock will last longer than it typically does. Some new patients are still being prescribed insulins that will soon be discontinued, resulting in avoidable transition challenges.¹

The Challenges in Insulin Transitions

Transitioning patients to alternative insulin products presents several challenges¹:

Practical Strategies for Effective Insulin Transitions

1. Early Identification and Communication

Proactively identify all patients using insulins that are soon to be discontinued. Prioritize based on glycemic control, comorbidities, and social support.¹
 

2. Selecting Appropriate Alternatives

When selecting alternative insulin products, consider:

• Pharmacokinetic profiles¹
• Patient specific factors and preference¹
• Access, affordability, and insurance coverage^3,4,6
• Availability of suitable delivery devices and patient’s ability to use them effectively¹
   

3. Conducting Effective Transition Discussions

To increase confidence when discussing transitions with patients:

Implementing Effective Transition Strategies

Healthcare teams can benefit from developing standardized protocols for insulin transitions, including:

• Maintain a registry of patients using insulins that are soon to be discontinued.¹
• Provide comprehensive education on alternative insulin products, including proper handling and methods of administration.¹
• Monitor blood glucose regularly after any change in insulin to ensure appropriate dosing and glycemic control.¹

For insulin products not available in a disposable pen/device, HCP may need to educate patients on how to load cartridges into reusable pen devices.¹ This education should occur both at the point of dispensing and during administration.

Reducing the Burden Through Effective Communication

Patients may be hesitant about switching insulin products due to concerns about effectiveness, side effects, or changes to their routine. HCPs can help address these concerns by:^1,2

1. Acknowledging patient concerns and validating their feelings about changing their established regimen
2. Explaining the reason for the switch and the selection process for the alternative insulin
3. Providing clear instructions on the alternative insulin product and dosing
4. Discussing proper use, handling, and method of administration
5. Ensuring the patient understands storage requirements and costs
6. Scheduling appropriate follow-up to monitor response to the new insulin

By approaching these conversations with confidence, preparedness, and empathy, HCPs can transform a challenging situation of insulin transitions into a productive patient engagement journey.

Conclusion