I am a retired internal medicine doctor. Many people worry about the high cost of insulin and the fact that some diabetic patients have died because they cannot afford insulin. What the pharmaceutical industry is doing with insulin prices is outrageous and unconscionable. However, no one has to go without insulin because there is a cheaper option.

There are two older insulins, NPH (longer acting) and Regular (shorter acting), which cost about $25 a vial at Walmart. They are less convenient because the person using them needs to eat on a stricter schedule than with the newer insulins. Regular (shorter acting) insulin takes longer to start working and lasts longer in the body than the newer rapid and short acting insulins. NPH insulin levels rise gradually to a peak several hours after the injection. It is not a smooth level like the newer long-acting insulins. Because of those differences, people need to be careful about the timing of meals and snacks.

For Type 2 diabetes, NPH and Regular provide similar diabetic control to the newer insulins. For Type 1 diabetics, the newer insulins are preferable. However, Type 1 diabetes can be managed with NPH and Regular insulin if necessary. Type 1 diabetics cannot live without insulin. If you have Type 1 diabetes, do not go without insulin. Talk with your doctor about your financial situation and ask to be put on NPH and Regular.

NO ONE who requires insulin to manage their diabetes should go without insulin.

Nina Ainslie, Manhattan