Hello everyone

[Glück]

Hello everyone.
Are there any UK residents from Russia here? How does the transition from a Russian insulin to a foreign one go? How do endocrinologists pick a dose? I'm moving to the UK and would like to get some information or tips on the subject please.
Diagnosed in 2008.
I get RinFast Nik (Rinastra II, aspart) ≈20/day
and Levemir (detemir) 8×2/day.

 

[Inka]

Welcome @Glück 🙂 If the Rinfast is just an aspart insulin, you’ll probably be swapped to Novorapid, which is the original aspart insulin. Levemir is a common basal/slow insulin in the U.K. but it’s being discontinued so you might be kept on Levemir or you might be changed to a new basal insulin.

The important things are to check your visa and health entitlement in the U.K.; bring enough of your Russian insulin with you to last you at least 3 months, and also bring other diabetes supplies; and register with a GP (general doctor) as soon as you can once you get to the U.K. as you’ll get your insulin prescriptions from your GP.

 

[Glück]

Thank you very much for such a substantial explanation.

 

[rebrascora]

Hi and welcome.

Is your Rin Fast Nik one of the faster insulins. ie aspart with an additive to make it a bit faster? If so, Fiasp would be your equivalent, if not then NovoRapid or Trurapi which is a generic equivalent to NovoRapid but both are insulin aspart.
As mentioned, Levemir is being phased out worldwide I believe. Certainly in the US and next year in the UK, which many of us are very unhappy about as there is not currently a generic equivalent. We are still being prescribed Levemir for now, but stocks are expected to run out next year and consultants are already starting to have conversations about a suitable alternative for each patient based on their needs.

 

[Glück]

Hi and welcome.

Is your Rin Fast Nik one of the faster insulins. ie aspart with an additive to make it a bit faster? If so, Fiasp would be your equivalent, if not then NovoRapid or Trurapi which is a generic equivalent to NovoRapid but both are insulin aspart.
As mentioned, Levemir is being phased out worldwide I believe. Certainly in the US and next year in the UK, which many of us are very unhappy about as there is not currently a generic equivalent. We are still being prescribed Levemir for now, but stocks are expected to run out next year and consultants are already starting to have conversations about a suitable alternative for each patient based on their needs.

Thank you for your reply. I reckon RinFast doesn't have any additives. Besides, I used to get NovoRapid.
What about Levemir? Are there any decent substitutes?

 

[mashedupmatt]

Hi @Glück and welcome to the forum - there are no direct substitutes for Levemir at present - the closest thing would probably be an intermediate insulin such as Humulin I but it's not been decided just yet on what health care teams will prescribe - there is likely to be some kind of update shortly - this page has some useful information regarding insulin shortages/discontinuations

What you need to know about insulin supply issues in the UK

Humulin insulin vials discontinuation On 23 July 2025, the DHSC issued a Medicine Supply Notification for Eli Lilly's Humulin insulin range in 10ml vials, which are being discontinued. This includes:

www.diabetes.org.uk

 

[Inka]

Thank you for your reply. I reckon RinFast doesn't have any additives. Besides, I used to get NovoRapid.
What about Levemir? Are there any decent substitutes?

Sadly, there are far fewer insulins available now than when I was diagnosed 30+ years ago. If you take your Levemir twice a day and prefer that, then you could have Hypurin Isophane or Humulin i (isophane) which are both twice daily insulins.

From what I’ve heard, they’re trying to swap many people to Tresiba (Insulin degludec), which is a once daily insulin. This would work best for people whose basal insulin needs are fairly even through the day and night, but would be trickier for those whose needs differ. For those people, Hypurin Isophane or Humulin I would probably be better. When I take a pump break, I use Hypurin Isophane, and I’ve found it very flexible.

 

[Inka]

Hi @Glück and welcome to the forum - there are no direct substitutes for Levemir at present - the closest thing would probably be an intermediate insulin such as Humulin I but it's not been decided just yet on what health care teams will prescribe - there is likely to be some kind of update shortly - this page has some useful information regarding insulin shortages/discontinuations

What you need to know about insulin supply issues in the UK

Humulin insulin vials discontinuation On 23 July 2025, the DHSC issued a Medicine Supply Notification for Eli Lilly's Humulin insulin range in 10ml vials, which are being discontinued. This includes:

www.diabetes.org.uk

Yes, so many discontinuations and pushing people onto different insulins or different delivery methods. I wish I could find a list of the great choice of insulins we had when I was first diagnosed. If an insulin didn’t suit you, there were always others to try, now everyone is being squeezed into a One Size Fits All regime. Roll on a cure!

 

[rebrascora]

The main 3 choices I was given to replace Levemir were:-

Tresiba which is a very long acting insulin and is taken once a day but each dose overlaps the previous one as the activity time is about 36hours. Not great if you need to adjust for exercise or time of the month or you need much less insulin during the night than you do in the day like me (I need 22 units of Levemir in the morning but only about 3units at night and sometimes none at night if I have don't lots of exercise for a few days) Tresiba provides very stable basal cover if that is what you need, but absolutely wouldn't suit me.

Toujeo which is a triple strength Glargine insulin. Again not very flexible at all.

Lantus which is also insulin Glargine but single strength and probably the closest of those 3 to Levemir and can be split into two separate doses, but isn't quite as flexible as Levemir.

However, I had done my homework before I went to see the consultant and had decided that I would prefer an older insulin, Humulin i which is a genuine twice a day intermediate insulin and therefore, whilst quite different in type from insulin Determir, should give me the flexibility I need. My consultant agreed in principal that it would be the best match for me but has concerns that with it being an "old fashioned" insulin, might at some point be discontinued too. So that is my first choice for a replacment at the moment...... unless a company develops a generic Determir for the market before next year, which is unlikely but keeping my fingers crossed.

 

[trophywench]

Yes, so many discontinuations and pushing people onto different insulins or different delivery methods. I wish I could find a list of the great choice of insulins we had when I was first diagnosed. If an insulin didn’t suit you, there were always others to try, now everyone is being squeezed into a One Size Fits All regime. Roll on a cure!

Well, exactly, especially as we started off with the choice between porcine and bovine, if nothing else. But once they started inventing un-natural ones, wow!

 

[Inka]

Well, exactly, especially as we started off with the choice between porcine and bovine, if nothing else. But once they started inventing un-natural ones, wow!

I tried to Google to see if I could find a list of the insulins then, but only found this US page below. However, even that says there were about 30 different insulins. Having less isn’t an improvement at all. It’s trying to squeeze everyone down the same path:

Animal Insulin Withdrawal: Lessons for Patient Advocates Today

Canadians, too, are struggling with the rising cost of insulin therapy, as James Elliott has noted. This situation has come about in part because governments have given 100% control of the supply of insulin to global manufacturers, three of which now control 95% of the world market.

www.t1international.com

“Until the mid-1990s, the range of available insulins was much more diverse, not to mention much more affordable. There were about 30 distinct types of insulin including 6-9 different options in the Lente family (Lente, Semilente and the 36-hour, no peak Ultralente), NPH and Regular. Most of these came in beef, pork or a mixed beef/pork formulation”

 

[Ieva DUK]

Hi @Glück, and welcome to the forum!

It looks like you’ve already received some really helpful and detailed replies - there’s a lot of collective wisdom here as you can tell, and it’s great that you’re asking ahead of your move.

As others have mentioned, your current insulins (RinFast/NovoRapid and Levemir) have direct or near equivalents here in the UK, though the situation with Levemir is changing. It’s frustrating that there are fewer choices now than in the past, especially when flexibility is so important with diabetes management. Hopefully your UK diabetes team will work with you to find a replacement that suits your needs best - and it sounds like you’re already well-informed and clear on what works for you, which will help a lot in those conversations.

It’s definitely worth bringing a few months’ supply of your current insulins and supplies if you’re able to, just to give yourself breathing room while settling in and sorting NHS registration and referrals. Once you're registered with a GP, depending on your location they can connect you with a diabetes clinic or specialist who can support your transition to new insulins if needed.

Wishing you all the best with your move - feel free to keep us posted or ask anything else as you go. There’s a great community here who understand the ins and outs.