A Utah mother is fighting for her teenage daughter’s access to diabetes medicine.

Ruby Smart, 15, has been taking Levemir (detemir) insulin since she was diagnosed with type 1 diabetes more than two years ago.

“Levemir is uniquely suited to her situation,” Alison Smart, the girl’s mother, told Fox News Digital in an interview.

The family was stunned when Novo Nordisk, the Denmark-based manufacturer of Levemir, announced in November 2023 that the drug was being discontinued.

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Smart has now made it her mission to convince Novo Nordisk to continue making Levemir — or to find a pharmaceutical company to create a biosimilar (generic) alternative.

Levemir is a long-acting basal insulin that’s injected once or twice a day to control high blood sugar in adults and children with diabetes, according to Novo Nordisk’s website.

For Smart’s daughter, an active athlete who plays on the tennis team at Woods Cross High School, Levemir has enabled her to continue with her regular activities while controlling her diabetes.

While there are a couple of other types of basal insulin on the market, Smart said Levemir is best suited to her daughter’s needs.

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“Levemir is unique in that it is a relatively shorter-acting basal insulin, making it ideal for those with fluctuating basal insulin needs, including teenagers, menstruating women, pregnant women and athletes,” she said.

“The two remaining insulins also have side effects we don’t worry about when using Levemir.”

“She’s super active and plays tennis almost every day,” Smart said of her daughter, pictured here. “The pump was fine for daily activity, but for tennis tournament days, it didn’t work.” (Alison Smart)

They did try an insulin pump for a few weeks, which is a wearable device that provides a steady flow of insulin to the body. But Smart said it was not compatible with her daughter’s high activity levels.

“She’s super active, and plays tennis almost every day,” Smart said. “The pump was fine for daily activity, but for tennis tournament days, it didn’t work.”

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Smart is advocating for people to be able to choose. 

“The bottom line is that Levemir works for us,” she said. “Our lives are much easier and less complex on a regimen of multiple daily injections using Levemir insulin.”

Reasons for discontinuation

Novo Nordisk provided three main reasons for why it’s discontinuing Levenir.

“After careful consideration, we made this decision because of global manufacturing issues, decreasing patient coverage, and because we are confident that patients in the U.S. will be able to find alternative treatments,” the company said in a press release.

Novo Nordisk announced in Nov. 2023 that Levemir would be discontinued. “During this time, we strongly encourage that health care professionals and patients discuss transitioning to alternative treatment options prior to the discontinuation date,” the company said in a statement. (LISELOTTE SABROE/Scanpix Denmark/AFP)

When contacted by Fox News Digital, Novo Nordisk provided the following recommendation to doctors and patients.

“During this time, we strongly encourage that health care professionals and patients discuss transitioning to alternative treatment options prior to the discontinuation date. Novo Nordisk, along with other companies, provides a number of alternative treatment options for people living with diabetes who require basal insulin.”

The company suggested that patients switch to other basal insulin options, including but not limited to Basaglar, Insulin Degludec, Insulin Glargine U-300, Lantus, Rezvoglar, Semglee, Toujeo and Tresiba.

“The other options for basal insulin are not equal and are not sufficient — they have different side effects and different qualities.”

Many parents, however, say these alternatives are not the same.

“The other options for basal insulin are not equal and are not sufficient — they have different side effects and different qualities,” Smart told Fox News Digital. 

“They’re not as flexible, and not as easy to use with someone who has varying basal insulin needs, like a teenager.”

Alison Smart, far right, is pictured with two other parents of teens with type 1 diabetes in Washington, D.C.  (Alison Smart)

Other parents are also concerned about being forced to switch medications.

Jaime Losinski, a mother in Tampa, Florida, has a 14-year-old son with type 1 diabetes. He’s been taking Levemir for years.

“Levemir is a valuable insulin for children and teens, who have ever-changing insulin needs as they grow,” she told Fox News Digital.

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“Levemir’s action profile makes it perfect for patients who need to make rapid and continual changes,” she went on. 

“An insulin such as Lantus or Tresiba, which the industry tells us to ‘just switch to,’ lasts far too long in the system for someone like him and would be dangerous overnight,” she said. “They also come with side effects, all of which he experienced when we tried them both shortly after his diagnosis seven years ago.”

Smart teamed up with other parents to form the Alliance to Protect Insulin Choice. She has also visited Washington, D.C., twice to meet with senators and congressional representatives. (Alison Smart)

Although Levemir is expected to be available until Dec. 2024, Smart said providers have warned her to “expect supply disruption” in the meantime.

Some insurance companies have already stopped coverage of the drug due to the discontinuation.

Smart received a letter from her insurance company in November saying Levemir would not be on her plan any longer. They later agreed to add it back on — but only if she paid a premium.

‘Not as cut and dry as it might seem’

Erin Palinski-Wade, a certified diabetes educator in New Jersey, said the discontinuation of Levemir is “understandably surprising and frustrating” for patients who rely on this brand of insulin.

“Although there are other forms of long-acting insulin on the market, each has its own slight differences, such as peak times, which can have a significant impact on blood glucose management during the day,” she told Fox News Digital. 

“For children and teens, there may be greater fluctuations in blood sugar.”

“Transitioning from one brand of insulin to another is not as cut and dry as it might seem, and can lead to periods of high blood sugar or hypoglycemia episodes (dangerously low blood sugars) as the adjustment occurs,” Palinski-Wade added.

For parents who rely on Levemir, the expert recommended working with a physician, endocrinologist and/or dietitian to create the “best transition plan possible” to minimize fluctuations in blood sugar while finding an alternative that works best.

“Levemir is a valuable insulin for children and teens, who have ever-changing insulin needs as they grow,” a mother said. (iStock)

When transitioning to a new insulin, increased testing of glucose levels is needed to prevent and correct highs and lows as they occur, Palinski-Wade noted.

“This is especially important for children and teens, as there may be greater fluctuations in blood sugar due to activity, growth and hormone fluctuations,” she said.

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Tanya Freirich, a certified diabetes educator in New York City working as The Lupus Dietitian, agreed that the closest replacement in terms of duration of action is Lantus (insulin glargine). 

“One of the differences is the peak time,” she told Fox News Digital.

“Lantus peaks [or lowers the blood sugar the most] at six hours after administration, while Levemir peaks at eight to 10 hours after administration. This difference would affect the appropriate timing for the medication to prevent dangerous blood sugar lows.”

Dr. Marc Siegel, clinical professor of medicine at NYU Langone Medical Center and a Fox News medical contributor, said he is also disappointed by the news of the discontinuation. (Fox News)

Dr. Marc Siegel, clinical professor of medicine at NYU Langone Medical Center and a Fox News medical contributor, said he is also disappointed by the news of the discontinuation.

“It is based on supply chain and production issues rather than a problem with the product,” he told Fox News Digital.

“We definitely need biosimilar versions to replace it,” he said. “It can be life-saving.”

“It is based on supply chain and production issues rather than a problem with the product.”

“Some patients really need a version of insulin and Levemir may be their best option.”

Although Levemir is “very similar” to Lantus, Siegel said, it has two important differences: “It causes less weight gain and less hypoglycemia (low glucose).”

Advocating for access

After Novo Nordisk’s November announcement of the discontinuation, Smart sprung into action.

She set up an online petition and began contacting the Food and Drug Administration and the World Health Organization.

“This drug is on the World Health Organization’s list of essential medicines,” she said. “I just couldn’t wrap my head around the possibility of this happening and people not being as outraged as I was.”

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Smart also teamed up with other parents to form the Alliance to Protect Insulin Choice. She has visited Washington, D.C., twice to meet with senators and congressional representatives.

“Our goal is to have Novo Nordisk slow down the discontinuation, and produce Levemir insulin for a few years until a biosimilar is widely available,” she said.

“We would like to find a biosimilar manufacturer to make this insulin, so it stays available.”

An insulin pump, a wearable device that provides a steady flow of insulin to the body, was not compatible with her daughter’s high activity levels, said Smart of Utah. (iStock)

While Smart recognizes that the medication may not be available “forever,” she aims to slow down the discontinuation and keep Levemir available for a few more years — “because it will take that long to get a biosimilar up and running.”

Smart’s efforts have also caught the attention of billionaire Mark Cuban, who expressed his willingness to partner with Novo Nordisk to continue producing Levemir.

When contacted by Fox News Digital, Cuban said that his pharmaceutical company, CostPlus Drug Company, is “trying to figure out a way to source [Levemir].”

“We aren’t there yet, but we are trying,” he said.

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Many regions across the United States experienced “record-breaking high temperatures” in 2023 due to extreme heat, according to the Centers for Disease Control and Prevention (CDC).

Emergency room visits due to heat-related illness peaked in several regions in the U.S. and remained elevated for a prolonged duration compared to visits between 2018 and 2022, the agency’s recent Morbidity and Mortality Weekly Report noted.

More males went to the emergency room for heat-related illnesses than females – especially those between 18 and 64 years old.

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Americans are experiencing “longer, hotter and more frequent episodes of extreme heat,” the report states.

Is extreme heat a public threat?

“Extreme heat could be considered an invisible killer in so much as many people become exposed and vulnerable to its dangers quickly and often without warning,” Patrick McHugh, M.D., an emergency medicine physician at Cleveland Clinic Akron General in Akron, Ohio, told Fox News Digital.

Although McHugh said Americans “shouldn’t worry,” he emphasized the need to “be aware and prepared for the dangers of heat waves.”

An EPA spokesperson told Fox News Digital, “As average temperatures rise due to climate change, the risk of extreme temperatures, heat waves and record-breaking temperatures increases.”

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Here’s what to know about extreme heat and how to stay safe.

What is extreme heat?

“Extreme heat can be defined depending on a variety of factors, including location, weather conditions (such as cloud cover, humidity and temperature), and the time of year,” said an EPA spokesperson in an email.

It typically occurs when the weather is much hotter and/or more humid than average in a particular area, the agency added.

Emergency room visits due to heat-related illness peaked in several regions in the U.S. and remained elevated for a prolonged duration compared to visits between 2018 and 2022. (iStock)

While summertime temperatures of 100 degrees Fahrenheit might be normal for Phoenix, Arizona, for example — the same temperatures are considered extreme for Boston, Massachusetts.

“Where in the U.S. people are most susceptible to heat depends on what is normal for a given location and the type of infrastructure (such as access to air conditioning),” the EPA spokesperson noted.

“Extreme heat is becoming more common in places that have not historically experienced extreme heat … and don’t have the infrastructure to keep people cool, which has major consequences for health and safety.”

“Extreme heat could be considered an invisible killer … as many people become exposed and vulnerable to its dangers quickly and often without warning.”

A heat wave is typically defined as a “prolonged period of abnormally hot weather, usually lasting more than two days in a row,” the EPA spokesperson said.

Heat waves can occur with or without humidity.

The average global temperature has risen by more than 2 degrees Fahrenheit since the mid-1800s, according to McHugh.

Elderly adults, infants, individuals taking certain medications and people with disabilities are at greater risk of heat-related illnesses. (iStock)

“This results in greater extreme heat temperatures, increased variability in temperatures and an increase in the risk of heat illness,” he told Fox News Digital.

The EPA’s Heat Waves indicator, which monitors trends in heat waves for 50 cities across the U.S. over the past 60 years, shows that heat waves are occurring more often over a longer period of time — both in average number of days and season length — and are also becoming hotter over time.

Risk factors for extreme heat effects

Elderly adults, infants, individuals taking certain medications and people with disabilities are at greater risk of heat-related illnesses, according to McHugh, who has a specialty in wilderness medicine.

These individuals may not have adequate resources to escape the heat and protect themselves, he warned.

“Extreme heat is becoming more common in places that have not historically experienced extreme heat … and don’t have the infrastructure to keep people cool, which has major consequences for health and safety,” an EPA spokesperson said. (iStock)

“Many schools in northern parts of the U.S. do not have air conditioning, so when heat waves happen in May/June or [in] September, students and teachers can be at risk,” the EPA spokesperson noted.

Certain factors can also increase someone’s risk of developing a heat-related illness, including fever, dehydration, prescription drug use, alcohol use or sunburn, according to the CDC.

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Healthy people can be at risk if they engage in strenuous physical activity when it’s very hot outside — which means it’s important to balance activities with actions that cool the body to prevent heat-related illness, the EPA advised.

Certain settings — such as inside cars, construction worksites and homes with little to no air conditioning — can also put people at greater risk, according to the CDC.

Heat island effect

Some urban areas experience higher temperatures compared to outlying areas.

“Structures such as buildings, roads and other infrastructure absorb and re-emit the sun’s heat more than natural landscapes like forests and water bodies,” the EPA spokesperson said.

These highly concentrated areas, which have limited greenery, become “islands” of higher temperatures relative to outlying areas.

It’s important to balance activities with actions that cool the body to prevent heat-related illness, the EPA advised. (iStock)

“Daytime temperatures in urban areas are about 1 to 7 [degrees Fahrenheit] higher than temperatures in outlying areas, and nighttime temperatures are about 2-5 [degrees Fahrenheit] higher,” the agency noted.

People living and working in these areas are at higher risk of heat-related illness and death.

“Prolonged exposure to high temperatures is associated with increased hospital admissions for cardiovascular, kidney and respiratory disorders.”

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As people lose control of their internal temperature amid extreme heat, they may experience a range of illnesses, including heat cramps, heat exhaustion, heat stroke and hyperthermia, according to the EPA.

“Prolonged exposure to high temperatures is associated with increased hospital admissions for cardiovascular, kidney and respiratory disorders,” the spokesperson said.

A particular setting can also place people at high risk, including inside cars, construction worksites and homes with little to no air conditioning, according to the CDC. (iStock)

Some 1,220 people die of heat-related illness every year in the United States due to extreme heat, per CDC estimates.

“Heat islands also increase energy demand for cooling, which can increase greenhouse gas emissions and air pollution and can be a financial burden for many people — particularly low- or fixed-income households,” the EPA spokesperson said.

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Everyone should have a plan in case of extreme heat, McHugh advised. “Either an air-conditioned home or building where shelter from the heat is easily available should be used.”

Extreme cold is dangerous, too 

Those who counter climate change claims warn of extreme temperatures at both ends of the spectrum.

Most studies have shown that extreme cold causes about 10 times more excess deaths than extreme heat, according to William Happer, PhD, professor emeritus of physics at Princeton University in New Jersey and a prominent critic of climate extremism.

Most studies have shown that extreme cold causes about 10 times more excess deaths than extreme heat, according to a physics professor. (iStock)

A 2015 international study that analyzed deaths between 1985 and 2012 in 13 countries, including the U.S., found that most of the deaths due to adverse temperatures were attributable to cold weather.

The study, which was published in The Lancet, also revealed that most deaths were caused not by extreme temperatures, but by exposure to moderately hot and cold temperatures. 

A more recent study published in The Lancet Planetary Health in 2021 found that for every death associated with heat, nine were connected to cold.

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“No one knows how much of the modest recent warming, around 1 [degree Celsius] over the past century, has been due to greenhouse gases and how much is natural,” Happer told Fox News Digital.

He estimates that less than half of the warming is from increasing greenhouse gases.  

“Whatever the cause, observations clearly show that there has been very little change in daily high temperatures,” Happer noted.

A more recent study published in The Lancet Planetary Health in 2021 found that for every death associated with heat, nine were connected to cold. (Credit: Fox News)

“The warming is almost all due to warmer minimum temperatures at night and in the winter.”

Compared to lives lost due to the extreme heat, the warming should have saved more lives that would have been lost because of the extreme cold, he said.

For local heat and health information, the EPA spokesperson recommended using the CDC’s Heat and Health Tracker. 

Americans can also visit their local National Weather Service (NWS) Forecast Offices for real-time heat-related warnings.

Fox Weather can also be consulted on a regular basis for up-to-date weather information and news. 

For more Health articles, visit www.foxnews.com/health.

• The World Health Organization has approved a new version of a widely used cholera vaccine that aims to address a surge in cases.
• The new vaccine uses fewer ingredients and can be made more quickly and cheaply.
• It remains effective at preventing the disease, according to recent research conducted in Nepal.

The World Health Organization has approved a version of a widely used cholera vaccine that could help address a surge in cases that has depleted the global vaccine stockpile and left poorer countries scrambling to contain epidemics.

WHO authorized the vaccine, made by EuBiologics, which also makes the formulation now used, last week. The new version, called Euvichol-S, is a simplified formula that uses fewer ingredients, is cheaper, and can be made more quickly than the old version.

The vaccine was shown to be help preventing the diarrheal disease in late stage research conducted in Nepal.

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WHO’s approval means donor agencies like the vaccines alliance Gavi and UNICEF can now buy it for poorer countries. Leila Pakkala, director of UNICEF’s supply division, said in a statement that the agency will be able to boost supplies by more than 25%.

Gavi estimated there could be about 50 million doses for the global stockpile this year, compared with 38 million last year.

Dr. Derrick Sim of Gavi called WHO’s authorization “a lifeline for vulnerable communities around the world.”

More is still needed, however: Since January, 14 countries affected by cholera outbreaks have requested 79 million doses. In January, the U.N. agency said the global vaccine stockpile was “entirely depleted” until the beginning of March. As of this week, WHO said there were 2.3 million doses available.

Cholera is an acute diarrhea disease caused by a bacteria typically spread via contaminated food or water. It is mostly seen in areas that have poor sanitation and lack access to clean water. While most people infected with cholera don’t experience symptoms, those with severe cases need quick treatment with intravenous fluids and antibiotics. If left untreated, cholera kills about a quarter to half of people infected.

Since last January, WHO has reported more than 824,000 cholera infections, including 5,900 deaths worldwide, with the highest numbers of cases reported in the Middle East and Africa. The U.N. agency said warming temperatures that allow the cholera bacteria to live longer, have also worsened outbreaks and led to the highest death rates in a decade.