Every month, Sweet Life co-founder Bridget McNulty discusses something personal about life with diabetes. This month, she unpacks donating insulin…
The recent insulin shortage in two Eastern Cape public hospitals (Dora Nginza and Livingstone) resulted in a flood of requests for insulin donations. We often get emails from well-meaning people who have extra insulin pens and don’t want them to expire, and so would like to donate them.
But there’s a lot to think about when it comes to donating insulin… It’s actually a very complicated and emotional topic. I’m not pretending to have all the answers, but here are some of the questions.
Is donating insulin legal?
The first thing to think about, of course, is whether it’s legal. Insulin is a prescription drug that is specifically prescribed to an individual. So trading insulin (whether for money or by donation) is illegal, as the prescription does not apply to whoever the insulin is being donated to. Apparently there are also people who abuse insulin, and of course it can be lethal if taken in large doses.
Is it the same type of insulin?
If the illegal aspect isn’t a factor, it’s important to think about the different types of insulin. In South Africa, many public hospitals still prescribe human insulin, some prescribe analogue, very few prescribe the newer ultra-rapid and ultra-long-acting insulins, as they are more expensive.
Donating an insulin that doesn’t match what someone is currently using can be dangerous, as the dosage and timing might be different, resulting in big blood sugar fluctuations.
Can you guarantee the cold chain?
And then there’s the practicality of donating insulin. If you are handing it to someone who you know is living with Type 1 diabetes and uses the same insulin as you and can take the carefully wrapped insulins in their cold pack straight home to a fridge, that seems pretty safe. But if you’re sending it to another province or city, can you guarantee the cold chain?
In other words, can you guarantee that the insulin will remain at the necessary stable cold temperature from the time it leaves your home to the time it arrives in the home of the person who needs it? That’s a big ask for any of us… particularly with loadshedding.
Is this a problem for individuals to fix?
And then, of course, there’s the bigger question: is this a problem for individuals to fix, or do we actually have to hold our government accountable for providing enough life-saving insulin to people with diabetes? Where is the line between being helpful and enabling a broken system to stay broken? And at the same time, why should individuals have to suffer for a broken system, if we can possibly help them?
I don’t know any of the answers to these questions, but I do know that we need to ensure that the underlying problem is being addressed at the same time as providing immediate help. The Eastern Cape Health Department claimed they were resolving the problem urgently last week – does that mean it won’t happen again?
So what can you do?
The problem with all these facts, of course, is that the end result is: “oh well, we can’t do anything to help then”. And that’s not right, is it? South Africa is a country of such inequality and inequity (where the inequalities are morally wrong) that we have to be able to have tools to help, in some way.
I have thought long and hard about what that help should look like. Sweet Life is a non-profit focused on diabetes education, so this isn’t our area of expertise (Diabetes SA has stepped in, with their community groups in each province). At the same time, though, we’re South Africa’s largest online diabetes community, and we deeply care about our community members.
I think that a possible solution for situations like this – as long as the government is being held accountable and is actually resolving the bigger issue – is to offer short-term relief through a registered pharmacy. We can delegate a pharmacy that is near to the hospital without access to insulin, and community members can go to that pharmacy with their clinic card that says they have Type 1 diabetes and which insulin they use. This insulin can then be dispensed for one month, and Sweet Life can cover the costs.
What do you think?
As I said, I don’t know any of the answers here, and I don’t want to take away from any of the excellent work that so many diabetes organisations are doing in this space. I do think it’s important to be aware of the potential complications of donating insulin, though… What do you think?
What to read next?
Let’s talk about insulin: Let’s talk about insulin- What kind of insulin do you use? How does it affect your life? How could better insulin make your life better? And why does the right basal insulin matter?
Let’s talk about telling all the stories of diabetes: Sweet Life co-founder Bridget McNulty discusses something that’s on her mind in the diabetes space. This month, she talks about telling all the stories of diabetes.
Photo by Ben Moreland on Unsplash.