I use insulin glargine pens, in small amounts, to bolster my metformin and improved diet. My auto-refill kicked in a while ago and I ran out but HEB told me they're on national backorder, so I used the Googletron and, sure enough, they're telling me the truth.

While looking into it, The Inflation Reduction Act, passed in 2022, caps the out-of-pocket cost for a month's supply of covered insulin at $35 for people with Medicare Part D plans. I'm not on medicare, but am on a private plan through my employer. A similar cap for Medicare Part B took effect on July 1, 2023, which also eliminated the deductible for insulin.

As usual, govt interference is making a mess of things. Price controls, every time they're tried, F things up beyond all recognition.

Anyone have any other reasoning as to the current supply issues?

Capping price of insulin
Seems like a great idea
With the best of intentions
What could possibly go wrong?

https://www.ashp.org/drug-shortages/current-shortages/drug-shortage-detail.aspx?id=1133

Looks like manufacturing difficulty keeping up with demand. This is just one manufacturer of one type of long-acting insulin. The alternatives are basically identical with the same efficacy. The long-acting insulin should be widely available under a different name like lantus or semglee.

Biden also promised to cure cancer. Of course he was only laughed at by conservatives for that.

It is not the insulin it is the delivery pens. Blame Ozempic. You can still get the insulin and inject it without the pen.

Not a diabetic, or pre-diabetic, but every man should be taking metformin by age 40.

CrackerJackAg said:

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Not a diabetic, or pre-diabetic, but every man should be taking metformin by age 40.

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Why..

doubledog said:

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It is not the insulin it is the delivery pens. Blame Ozempic. You can still get the insulin and inject it without the pen.

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There are still backorders for the vials. I don't deal in lots of glargine insulin, but the vials have had supply issues in the last few years intermittently. Some of this is one supplier, who doesn't produce GLP-1 products, absorbing an increased demand due to production shifts from the other suppliers to their clearly more profitable GLP-1s.

Aggies1322 said:

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CrackerJackAg said:

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Not a diabetic, or pre-diabetic, but every man should be taking metformin by age 40.

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Why..

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Studies are ongoing but it has fairly obvious "healthspan" benefits

Metabolic health & cardiovascular health the most studied.

Anecdotally: It does "something". I got my dad on it 10 years ago. Dude looks better today at 70 than he did at 60. No other changes.

I've been on it since age 35 when private doctor put me on it.
I feel great.

CrackerJackAg said:

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Aggies1322 said:

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CrackerJackAg said:

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Not a diabetic, or pre-diabetic, but every man should be taking metformin by age 40.

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Why..

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Studies are ongoing but it has fairly obvious "healthspan" benefits

Metabolic health & cardiovascular health the most studied.

Anecdotally: It does "something". I got my dad on it 10 years ago. Dude looks better today at 70 than he did at 60. No other changes.

I've been on it since age 35 when private doctor put me on it.
I feel great.

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What does it do though? Mechanically? Does it reduce the likelihood of insulin resistance because it helps your body use the insulin it's producing more efficiently? The two things you listed as benefits are also highly correlated to avoiding insulin resistance (which can be done through fasting and low carb diets). Curious about the mechanics behind why metformin would be doing these things.

I'd gander injecting chemicals into your body when you don't even need them vs a simple healthy lifestyle is not a good idea.

I use the vials and had to switch to pens and then back to vials.

I used to be a gigantic fatty. 6'7" and 600+ lbs. I was also SUPER diabetic, on the highest allowable human dosages of 4 different diabeetus meds (Metformin, januvia, and two others I can't remember).

Now, due to spinal issues from said fatassedness, I'm only 6'6" but am at 270-275. A lot of extra skin. When I graduated HS, I was 245 and in great shape. Would've made a great addition to the early 90s FTA football squad. I'm back in the pre-diabetic A1C world with better diet and metformin alone (pills) and a single small dose of long-lasting glargine. But, with the absence of the insulin, I'm noticing (via CGM) a slightly higher glucose level.

My insurance (UHG) stopped paying for Lantus this January, and only pays for the generic "Insulin glargine" named pens.

I really wish BOTH parties would quit interfering in markets. It never ends up better for us, the plebes. Ever. :-(

Ellis Wyatt said:

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I use the vials and had to switch to pens and then back to vials.

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Long-lasting or sliding scale?

Walmart has novolog pens and vials fairly cheap. They don't have an inexpensive "current" basal like Lantus.

if you're in a pinch, you can get vials of R insulin for $25 each OTC at the Walmart pharmacy without a prescription. Not as fast acting as novolog or humalog but it still works and you won't feel miserable.

Grassyass airmono

BigRobSA said:

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Ellis Wyatt said:

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I use the vials and had to switch to pens and then back to vials.

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Long-lasting or sliding scale?

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I had to switch to pens for glargine because of the shortage, but then they switched me back to vials. I use vials for sliding scale, too (Humalog) but didn't have to switch to pens of that.

CrackerJackAg said:

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Aggies1322 said:

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CrackerJackAg said:

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Not a diabetic, or pre-diabetic, but every man should be taking metformin by age 40.

---

Why..

---

Studies are ongoing but it has fairly obvious "healthspan" benefits

Metabolic health & cardiovascular health the most studied.

Anecdotally: It does "something". I got my dad on it 10 years ago. Dude looks better today at 70 than he did at 60. No other changes.

I've been on it since age 35 when private doctor put me on it.
I feel great.

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Regular fasting has the same effect and you don't have to put a chemical in your body to do it

txyaloo said:

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Walmart has novolog pens and vials fairly cheap. They don't have an inexpensive "current" basal like Lantus.

if you're in a pinch, you can get vials of R insulin for $25 each OTC at the Walmart pharmacy without a prescription. Not as fast acting as novolog or humalog but it still works and you won't feel miserable.

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I (unfortunately) have some experience in this subject.

The Novolin R vials contain an insulin that peaks at about 2 hours after injection and is pretty much done by hour 5 after injecting.

The Novolin N vials contain a longer-lasting insulin that will last about 12 hours.

Both are <$25 a vial without prescription at a Texas WalMart.

The insulin glargine (e.g. Lantus/Semglee) are longer-lasting still and will cover a 24-hour period.

If you run out of access to insulin glargine (a once per day dose), you could get by with taking the Novolin N twice per day.

But, you have to be careful here and experiment and probably consult your physician first.

I'm not sure that a unit of glargine and a unit of N have the same potency. If you take too much you could be in a world of hurt and possibly even kill yourself, so don't rely on some internet nut named 'Dr. Ribeye-Rare' to guide you on this. Please, please, please understand this, Big Rob. OK?

Roger that, good sir.

Aggies1322 said:

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CrackerJackAg said:

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Aggies1322 said:

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CrackerJackAg said:

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Not a diabetic, or pre-diabetic, but every man should be taking metformin by age 40.

---

Why..

---

Studies are ongoing but it has fairly obvious "healthspan" benefits

Metabolic health & cardiovascular health the most studied.

Anecdotally: It does "something". I got my dad on it 10 years ago. Dude looks better today at 70 than he did at 60. No other changes.

I've been on it since age 35 when private doctor put me on it.
I feel great.

---

What does it do though? Mechanically? Does it reduce the likelihood of insulin resistance because it helps your body use the insulin it's producing more efficiently? The two things you listed as benefits are also highly correlated to avoiding insulin resistance (which can be done through fasting and low carb diets). Curious about the mechanics behind why metformin would be doing these things.

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There is a recent study and I don't remember all of the details on it but it triggers a similar process at the cellular level as if you're hitting that 18 to 20 hours of fasting.

You are right on the metabolic side. There is going to be a lot to do with avoiding the insulin resistance. Which you can't really understate. A lot of things come from that and regardless of what you do, it's best to keep it as low as possible

Most people are not going to eat a low carb diet.

I WOULD NEVER WANT TO, but I could give up meat before I gave up rice and beans and avocados.

samurai_science said:

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CrackerJackAg said:

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Aggies1322 said:

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CrackerJackAg said:

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Not a diabetic, or pre-diabetic, but every man should be taking metformin by age 40.

---

Why..

---

Studies are ongoing but it has fairly obvious "healthspan" benefits

Metabolic health & cardiovascular health the most studied.

Anecdotally: It does "something". I got my dad on it 10 years ago. Dude looks better today at 70 than he did at 60. No other changes.

I've been on it since age 35 when private doctor put me on it.
I feel great.

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Regular fasting has the same effect and you don't have to put a chemical in your body to do it

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Sure. You could. Most people are not going to fast consistently. Most people are not going to eat low/no carb diets.

I fast on occasion, but not on any regimented schedule.

The point being is that this drug has been around for a very, very long time. Nobody makes a bunch of money selling it.

Every doctor I've dealt with, especially in the private field, universally prescribes it.

It is an absolute zero side effect type drug. Especially in the very small dose that I take it.

I think the most extreme side effect is gassiness for some people at the beginning.

Not an "chemicals" are bad.

Go OMAD + Keto.. you'll feel great and get the same result. Food is pretty good too. Lots of bacon and beef and avocado and cheese.

Aggies1322 said:

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Go OMAD + Keto.. you'll feel great and get the same result. Food is pretty good too. Lots of bacon and beef and avocado and cheese.

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Pass. I think the food on keto is extremely gross. If that works for you great. I do really well on a lot of chicken, rice beans, and avocado.

I eat that every single day for lunch.

I never eat breakfast and I eat dinner at 6:30 sharp every day. I never eat processed foods.

I'm not a big fan of ever being on a type of "diet".

I always feel great!

All I'm saying is do what works for you. Metformin is great for most people.

I'm not personally asking for advice as I am 45 and in great shape.

nomad2007 said:

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doubledog said:

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It is not the insulin it is the delivery pens. Blame Ozempic. You can still get the insulin and inject it without the pen.

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There are still backorders for the vials. I don't deal in lots of glargine insulin, but the vials have had supply issues in the last few years intermittently. Some of this is one supplier, who doesn't produce GLP-1 products, absorbing an increased demand due to production shifts from the other suppliers to their clearly more profitable GLP-1s.

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This sounds correct. As a type 1 diabetic, I take a fast acting insulin, in vials, and there have been supply problems for the last year. This explanation sounds right on the money.

Not complaining though, because the cost I used to pay for insulin would curl your toes, and now the price is negligible. Hopefully the supply problem doesn't worsen, but yes, price controls have consequences.

HEB gives my patients bad info all the time. They regularly tell them our device is on back order, not covered, etc. There are 3-4 companies selling Glargine now. I work in Endocrinology offices every day and have not heard of a shortage.