GPs ‘ought to focus on stopping’ semaglutide remedy for diabetes attributable to shortages

Sufferers with kind 2 diabetes on semaglutide and different glucagon-like peptide-1 receptor agonists (GLP-1 RA) medicine are having to cease taking them, amidst ongoing shortages attributable to reputation for weight reduction.

A Nationwide Affected person Security Alert this week requested clinicians to proactively establish sufferers established on all GLP-1 RAs for evaluate attributable to ‘very restricted, intermittent provides’ anticipated to final till the center of subsequent yr.

This could embody discussing stopping remedy with sufferers who haven’t achieved remedy targets as per NICE pointers.

The alert additionally reiterated that till provide points have been resolved the medicine ought to solely be used for his or her licensed indication and off-label prescribing for weight problems is ‘strongly discouraged’.

It follows a warning from the RCGP that unregulated use of semaglutide is posing ‘a real risk to affected person security’.

GPs had been first suggested to begin no new affected person on the medicine again in Autumn as international demand outstripped provide.

Within the newest alert, clinicians are additionally requested to not change sufferers between totally different manufacturers – together with between injectable and oral kinds – and to not double up on decrease dose preparations.

It added: ‘If switching a affected person on to insulin, please guarantee an insulin is chosen as per info on the SPS web page on prescribing obtainable insulins as not all suppliers are in a position to handle an uplift in demand.’

And it suggested that shifting to insulin would require schooling and coaching alongside elevated glucose monitoring to make sure sufferers perceive methods to recognise and handle hypoglycaemic occasions.

‘Present inventory should be conserved to be used in sufferers with diabetes. These shortages have critical medical implications within the administration of sufferers with kind 2 diabetes,’ the NPSA warned.

A Division of Well being and Social Care spokesperson stated they anticipated all suppliers of healthcare companies – NHS or non-public – to take ‘applicable account’ of nationwide steerage equivalent to Nationwide Affected person Security Alerts and Medication Provide Notifications.

‘The steerage is evident that these medicines ought to solely be prescribed for the remedy of kind 2 diabetes, in an effort to shield provide for diabetes sufferers.

‘Medicines that are solely licensed to deal with kind 2 diabetes shouldn’t be routinely prescribed for weight reduction.’

Esther Walden, deputy head of Care at Diabetes UK, stated: ‘It’s disappointing that the shortages are ongoing and are predicted to proceed till at the very least mid-2024, however we welcome this steerage for clinicians.

‘Whereas we perceive that off-label prescribing may be helpful in some circumstances, we can’t help it when it’s straight contributing to ongoing shortages for these folks dwelling with kind 2 diabetes and the influence this has on managing it nicely.’

Dr Douglas Value, a GP in Staffordshire, stated: ‘It has precipitated some further work swapping sufferers over to trulicity which remains to be in inventory or switching to different courses of medicines. Most of our sufferers who’re on GLP1-RA are on trulicity (Dulaglutide), if that additionally turns into scarce it will likely be way more of an issue.

He added that the logistics of introducing semaglutide for weight reduction within the UK appeared ‘poorly deliberate’.

‘It ought to’ve been clear to anybody {that a} as soon as weekly weight reduction remedy goes to be common. Non-public on-line suppliers, usually it appears utilizing GPs to prescribe, don’t have anyplace close to the identical hoops to leap by and sufferers merely populate an e-consult and pay the payment.

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