This page was last updated on 13 December 2024.
We have been concerned about the intermittent supply and shortages of glucagon-like peptide receptor agonists (GLP-1 RAs, or GLP-1 analogues), which are having serious implications for many people with type 2 diabetes, but have been told that the supply issues should be resolved in January 2025.
In this guide:
- Why are there supply issues with GLP-1 RAs?
- Prescriptions
- Private prescriptions
- Other effects of stopping GLP-1s
- Possible end of shortage
- What are Diabetes UK doing?
In June 2024, the World Health Organisation (WHO) issued a warning over fake versions of semaglutide which were identified in the UK. The WHO advised that semaglutide treatment should only come through a healthcare professional, and that semaglutide should not be bought online.
Why are there supply issues with GLP-1 RAs?
The NHS has been facing supply issues with GLP-1 RAs, a range of drugs used for managing blood glucose levels in people with type 2 diabetes.
The global shortage in supply was partly due to a surge in off-label prescriptions of the drug semaglutide being issued for weight loss which is outstripping supply.
Previously (since the summer of 2023) all stocks of GLP-1 RAs had to be reserved for those already using these medications, meaning that thousands of people who could benefit from these medications were not able to access them.
Prescriptions
I have been told there is no more supply of my GLP-1 RAs medication. Which of my medications is this?
There are different GLP-1 RAs for type 2 diabetes. They include:
- Dulaglutide (with the brand name Trulicity)
- Exenatide (which has the brand name Bydureon)
- Liraglutide (with the brand name Victoza)
- Lixisenatide (with the brand name Lyxumia)
- Semaglutide (with the brand name Ozempic or Rybelsus)
There is also semaglutide with the brand name Wegovy, but this is licensed for weight loss, not glucose management in type 2 diabetes.
And there is a medication called Mounjaro which works by activating both two receptors called GLP-1 and GIP to increase the level of incretins – hormones - in the body. Mounjaro was approved for treating type 2 diabetes in 2024.
My healthcare professional has stopped prescribing my GLP-1 RAs why is this?
There are three reasons why you might have been asked to stop your GLP-1 RA medication:
- Your healthcare professional has reviewed your response to this treatment and feels that it does not help you as intended.
- There may be supply issues, meaning that your medication is no longer available or may be out of stock for some time. There is a national shortage of these medications expected to last until the beginning of January 2025. Healthcare professionals have been reviewing people for alternative treatment where needed.
- You may have been previously prescribed this medication for an “off-label” use – these medications are only licensed for glucose management in type 2 diabetes (except for Wegovy and Mounjaro).
Can I be switched onto a different GLP-1 RA?
Since the summer of 2023 this was not permitted due to the shortages, but this changed in January 2024 when a National Patient Safety Alert (NPSA) was issued directing clinicians to allow people with type 2 diabetes who could benefit to be newly initiated onto Rybelsus.
The NPSA said that there is now sufficient stock of Rybelsus (semaglutide) tablets to allow people with type 2 diabetes who could benefit to be newly initiated on this form of GLP-1 RA.
People who have been prescribed Byetta and Victoza injections can be identified and their treatment can be changed to Rybelsus tablets. This is because Byetta is being discontinued in March 2024 and Victoza (liraglutide) continues to be out of stock and further stock is not expected until January 2025..
And in March 2024 NHS England confirmed that Mounjaro can be prescribed to people living with type 2 diabetes who are unable to obtain Ozempic, Trulicity or other GLP-1 medications, including people being newly initiated onto a GLP-1.
But in line with NICE guidance, your healthcare professional should still review whether the new medication is suitable for you before starting it and effective for you after you have started the treatment.
While I can get supply from the pharmacy, should I ask for a larger supply on prescription so that I don’t run out?
This is not recommended as this can affect supplies in other areas.
I was previously told that I would potentially need to start a GLP-1 RA at my next appointment, will that still happen?
The new guidelines for healthcare professionals now say that if you meet the NICE guidance criteria for a GLP–1 RA you could be newly prescribed Rybelsus or Mounjaro. If appropriate, your healthcare professional will discuss this at your next diabetes review.
What are the NICE guidance criteria?
NICE guidance for managing type 2 diabetes says that if triple therapy with metformin and two other oral drugs is not effective or not tolerated by the person taking the medication, healthcare professionals should consider triple therapy by switching one drug for a GLP-1 mimetic for adults with type 2 diabetes who:
- Have a body mass index (BMI) of 35 kg/m2 or higher (adjust accordingly for people from Asian, Black, and other minority ethnic groups) and specific psychological or other medical problems associated with obesity, or
- Have a BMI lower than 35 kg/m2, and when insulin therapy would have significant impact on their working life, or weight loss would benefit other significant obesity-related complications.
I still have supply of my GLP-1 RAs in the fridge, do I keep taking those for now?
Yes, continue to take your GLP-1 RA medication as normal and try to obtain re-supply as you usually would. If you have run out of GLP-1 RA and you can’t get re-supply as usual, it’s important to discuss this with your healthcare professional and find out if you have already been or are going to be prescribed an alternative treatment.
I have not had any problem obtaining supply of my GLP-1 RAs so far, when can I expect to be affected?
If you are established on a GLP-1 RA medication and have not been affected by the shortages so far, then it is likely you will be able to obtain your supplies as normal. But there may be a chance that there will be intermittent supply of certain products. You should keep taking your medication as usual but contact your healthcare professional if you run into problems collecting your prescription.
I know someone who is managing to get their GLP-1 RA, how come I can’t get mine?
Different GLP-1 RAs are experiencing different types of shortages. Some GLP-1 RAs are still being supplied to people already established on these medicines in some areas. It should be noted though that this has been affecting most GLP-1s, and until the situation is completely resolved there is no guarantee of continued supply with any of these medicines. Because of this uncertainty it is advised not to switch between products.
Are there some areas that have a better supply, and should I consider driving to a pharmacy out of my local area to get my prescription filled?
People are advised not to attempt to get supplies from other areas as all areas across the UK have been affected by these shortages.
It is possible that some different areas may be better stocked than others at different times, but this can change because different areas will receive delivery of stock at different times. It is still likely that any supply will be short-lived as supply continues to be less than demand. Pharmacies are being asked not to stockpile.
My child takes a GLP-1 RA, what do I do?
Continue to give your child their GLP-1 RA medication as normal and try to obtain re-supply as you usually would. If you have run out of GLP-1 RA and can’t get re-supply as usual, get in contact with the team that usually looks after their care.
This only mentions type 2 diabetes, I have type 1 diabetes or pre-diabetes and have been prescribed this medication. Will the shortages affect me?
The recommendations during the shortages are that people with type 2 diabetes should be prioritised. We support this because the GLP-1 RAs are licenced for managing glucose levels in people living with type 2 diabetes.
In September 2023, Novo Nordisk announced that a limited supply of Wegovy would become available to people in specialist NHS weight management services who meet the NICE eligibility criteria, or privately through a registered healthcare professional.
People who are prescribed Wegovy within these specialist NHS services will also receive support with dietary information and exercise.
Wegovy cannot yet be prescribed outside of specialist weight management services, which are largely hospital based.
The National Patient Safety Alert issued on 4th January 2024 stated that Saxenda (liraglutide) and Wegovy (semaglutide) remain available on the NHS via specialist weight management services.
I am on a GLP-1 RA and I can’t obtain my supply. My healthcare professional has said they will review me, but it might be a few weeks, is that OK?
Due to the number of people affected by this shortage it was recommended that people who were most at risk should be prioritised. This meant that some people needed to wait a little longer to be reviewed. If you think you should have been seen and are still waiting to hear, you should contact your diabetes healthcare professional about this.
If I stop my GLP-1 RA, will I be allowed to restart it when it becomes available again?
Everyone with diabetes should have a review with their health care professional periodically, and at least once a year. When supplies are regularly available again, your healthcare professional can discuss with you whether you would benefit from re-starting your GLP-1 RA treatment.
If you have had a good response to previous treatment and you would benefit from re-starting treatment, this may be appropriate for you. However, not everyone gets the intended benefit of treatment and so it may be that your healthcare professional might advise an alternative for you.
People can now be switched to Rybelsus and Mounjaro.
Am I better having it when I can get hold of it, even if that’s occasionally, rather than stopping entirely?
There is a chance that taking the medication sporadically may increase the risk of you experiencing side effects and may lead to unstable blood glucose levels. This could increase the likelihood of complications. This is of particular concern for people on insulin or sulphonylureas treatment, for example gliclazide or glimepiride.
Can I be prescribed a lower strength version of the GLP-1 RA and I double the dose instead?
No, this is not licenced and could affect supplies for people established on the lower doses.
Private prescriptions
If I get GLP-1 RA on private prescriptions, am I likely to also have problems or is this just a problem for NHS supply?
There has been a national shortage of these medication and there is no guarantee that private supply routes will continue. Healthcare professionals in the NHS can only advise about NHS prescriptions. You should contact your private practitioner if you want further information.
Should I buy GLP-1 RA privately?
It is not advised to pursue a private supply of these medications. There is no guarantee that there will be a continued supply privately and there is some concern that treatments being sold without a prescription may not be what they say they are.
Other effects of stopping GLP-1s
Will l gain weight when I stop the GLP-1 RA?
This will depend on if you lost weight when you started this medication. If you have lost weight, it increases the chance that weight will be regained after stopping. Talk to your healthcare professional to discuss alternatives such as weight management or remission programmes if you are concerned about weight gain.
Since stopping my GLP-1 RA I feel tired, thirsty and I am urinating a lot, what should I do?
These are the symptoms of high blood sugar levels and could lead to a serious condition called diabetic ketoacidosis (DKA). You should seek immediate medical attention.
Before I went on the GLP-1 RA I was told that I might have to go onto insulin, does that mean I will need to go onto insulin sooner?
Healthcare professionals should be prioritising people for review and will discuss with you your alternative treatment options. Treatment should be individualised for you and may involve other types of management such as changes to your diet or physical activity as well as a review of your medication.
I drive for a living and have been trying to avoid going on medications that cause hypoglycaemia, does this mean I am going to have to go onto something that will affect my driving licence?
You should raise any concerns about the impact on your driving licence with your healthcare professional and they will discuss with you your alternative treatment options. You can drive on a restricted licence even if you have a group 2 licence with both insulin and sulphonylureas, for example gliclazide and glimepiride.
Are there treatments I could try that do not involve taking more or different medication?
If you are concerned about taking alternative medication or putting on weight with a different medication you could ask your health care professional about referral to local or digital weight management programmes or a remission programme if it is relevant for you and available in your area.
You might also find diabetes education courses helpful if you have not done one for a while – ask your healthcare professional what is available locally. There are also now some digital courses available.
Possible end of shortage
When do you expect the shortages to come to an end?
Stock shortages are expected until at least the end of December 2024 for most affected GLP-1 RAs and until mid-January 2025 for Victoza
What are Diabetes UK doing?
We are supporting the recent guidance and are having ongoing discussions with the manufacturer and the Department for Health and Social Care about our concerns over how this is impacting people with diabetes. If this shortage is impacting on your mental health and wellbeing you can call the Diabetes UK Helpline – call 0345 123 2399.
