The Alliance to Protect Insulin Choice (APIC) is a volunteer-driven organization based in Utah made up of parents, caregivers, and individuals impacted by insulin-dependent diabetes. Their mission is to protect the autonomy of everyone who depends on insulin as a life-saving therapy to choose which insulin works best for them by lobbying for the support of local and national lawmakers as well as insulin manufacturers.
American Diabetes Association: An Introduction to Insulin
In people without diabetes, the pancreas makes and releases insulin at a steady rate throughout the day with extra bursts when blood sugar begins to rise. Modern medical insulin is created by adding the human gene for insulin to bacteria or yeast and is injected in doses to regulate blood sugar levels in people with diabetes.
The 5 main types of insulin are long-acting, intermediate-acting, regular insulin, rapid-acting and premixed. Just like people without diabetes, people with diabetes need unique doses of insulin that will stabilize their blood sugar throughout the day. There are many factors that affect insulin needs including pregnancy, age, menstruation, physical activity and more. There isn’t a one-size fits-all solution for the millions of people who rely on insulin.
The Loss of Life-Saving Medicine
Sixty-two different insulins have been discontinued in the past few decades, leaving these groups vulnerable and without choice. APIC aims to put more of these insulins back into production by getting governments and insulin manufacturers to understand the desperate need for these products.
APIC is committed to supporting people whose insulin needs vary, including many children, athletes and pregnant individuals. Some patients are unable to tolerate or do not achieve optimal control with the limited alternatives to Levemir. People with diabetes deserve access to the insulin options that best support their health and daily lives.
How a Mother’s Love Can Drive Change
Meet Alison Smart, founder and director of APIC. Smart is actively involved in raising public awareness, engaging in media outreach and communicating with insulin manufacturers and lawmakers to highlight the critical need for this unique insulin. She is also the parent of an athlete with type 1 diabetes who has used Levemir (a long-acting insulin) since before it was discontinued and continues to use what supply she has left. For Smart’s daughter, the choice to have the right treatment for her was life-saving, but now the insulin she depends on has been taken off the market.
“I started this because of my own daughter’s diagnosis. We found a treatment that worked — including a long-acting insulin called Levemir (detemir). For us, it wasn’t just a convenience — it was life. So when we learned Levemir was being discontinued in the U.S., we were devastated.” – Alison Smart
With over 8 million people in the U.S. relying on insulin everyday, it is a danger to the health of this significant portion of the population when they are forced to get used to new insulins or use ones that don’t work as well for them.
“When the manufacturer announced the discontinuation, we had no guarantee that a suitable alternative would exist. That uncertainty places many lives — especially those of children and pregnant women — at real risk.”
Myrthann Francisco
Myrthann has been living with Type 1 diabetes for over 50 years, and for the past 20 years Levemir has been the only insulin that consistently supported her through every stage of life, including her first three pregnancies. For many people, Levemir provides stability during times of hormonal fluctuation such as puberty, menstrual cycles, pregnancy and postpartum recovery. Without access to Levemir, millions of people who depend on it are put at serious risk.
When Levemir was taken off the market she was recommended two other “similar” insulins, but none of them worked for her. She is allergic to most other insulin formulations and they induce intense pain that she describes as feeling “like something is constantly gnawing on my spinal cord.” Another issue she had was during her fourth pregnancy when, after being forced to use an alternative insulin, she experienced serious complications. Her baby was born six weeks premature and had to spend several weeks in the NICU in order to survive.
“Not every single human body has the same needs,” Myrthann laments. “Without the ability to use what works best, the choice is dictated for us.” For Myrthann, and many other insulin-dependent Americans, the ability to choose Levemir is the ability to choose to live. When asked why the right to choose insulin was important to her, Myrthann stated simply, “I like to be alive, and be able to think, and to function.”
How You Can Help
Alison and the team at APIC are calling on companies and lawmakers to act. While insulin manufacturers make decisions that could help their bottom line, those same decisions affect millions of people. APIC is asking these manufacturers to compromise on solutions that benefit all insulin users. Lawmakers and government officials are also a piece of the puzzle. Regulations, legislation, tax incentives and more could force manufacturers to produce life-saving insulin.
Companies and lawmakers need a push in the right direction and you can help APIC in their mission.
- Contact your representatives
Tell your representatives to support legislation that protects insulin choice
- File a comment on the Citizen Petition to the FDA
For care providers or patients who have experienced harm with one of the few alternatives to detemir, follow the instructions below to file your comment.
Instructions
APIC is in discussions with a manufacturer and a distributor. If the FDA designates insulin detemir as a drug in shortage, manufacturing can begin.
They originally filed a Citizen Petition to the FDA in April 2025. This month (April 2026), we submitted amendments with a revised request.
Comments from care providers and patients experiencing harm with alternatives will carry a great deal of weight.
How to submit your comment:
- Go to this link
- Scroll to the bottom right where it says “comment” in a gray box. Submit your response.
- If that link doesn’t work, go to regulations.gov.
- Enter FDA-2025-P-1091 in the search bar
- Scroll to the bottom and click the gray “Comment” button and enter your response
- Select “Drug Industry”
- Enter your email address
- Say you’re an individual
- Submit
Thank you for taking the time to make your voice heard. Your perspective is valuable.
- Share this message
Share this blog and learn more at https://alliancetoprotectinsulinchoice.org/
- Donate
If you have the means to donate, APIC can use your charity to continue their efforts in securing insulin access
Resources
American Diabetes Association. (2011). American Diabetes Association complete guide to diabetes: the ultimate home reference from the diabetes experts. American Diabetes Association.