Diabetics complain obese people are using vital drugs

07/30/2023 Health News

We can’t get our diabetes jabs – because so many obese Britons are using them for slimming

Some 400,000 UK patients have the blood sugar condition type 2 diabetes
Many of those with type 2 diabetes use Ozempic known as semaglutide

Private clinics are flouting Government guidance by handing over prescriptions of vital diabetes drugs to dieters who use the jabs to lose weight, a Mail on Sunday investigation has discovered.

Ozempic, also known as semaglutide, and others like it are relied on by roughly 400,000 UK patients with blood sugar condition type 2 diabetes. But in recent months a shortage has led health chiefs to issue orders to ration prescribing.

Alongside controlling blood sugar, Ozempic – given via a self-injection pen – leads to dramatic weight loss. In studies, some patients shed a fifth of their bodyweight after a year of using the once-a-week treatment.

Rumours that A-listers – including reality TV star Kim Kardashian – used the drug to stay slim spread on social media and demand is now vastly outstripping supply.

Earlier this month, the Medicines and Healthcare Products Regulatory Agency (MHRA) issued a patient safety alert, ordering all doctors and pharmacists not to prescribe Ozempic and similar drugs to only aid weight loss. It said: ‘Existing stock must be conserved for use in patients with diabetes.’

But this newspaper has discovered online pharmacists still offering Ozempic for weight loss alone.

Manual, a men’s health company that also sells hair loss and erectile dysfunction treatments, charged £230 for an initial one-month supply, increasing to £299 a month on subscription. The company requires a full-length photo and photographic ID in order to verify would-be patients are the weight they claim to be – however messages to our reporter said that once this check was done, Ozempic was in stock and could be supplied. Our reporters were also approved for treatment by myBMI.co.uk after handing over £279, despite making it clear in an online consultation it was only going to be used as a diet aid.

In each case, we cancelled the orders before any medication could be sent out. Neither company responded when asked to comment on our findings. While there is no suggestion what they are doing is unlawful, medical leaders have criticised the practice in response.

High-profile GP Professor Dame Clare Gerada said: ‘Private providers should adhere to ethical guidelines and patients who need this drug for live-saving and life-protecting reasons should take priority.’ Novo Nordisk, Ozempic’s manufacturer, said: ‘We do not promote, suggest or encourage the off-label use or misuse of any of our medicines. We are continuing to work with MHRA and the Department of Health and Social Care to monitor the supply of our medicines and keep healthcare professionals updated.’

Readers’ frustration as MoS discovers online firms are defying Government to sell drug to dieters

By MOIRA PETTY and JONATHAN NEAL

Diabetes patients have vented their frustration at being unable to get hold of medication amid nationwide shortages – allegedly fuelled by dieters using the drugs to slim down.

Roughly 400,000 type 2 diabetics in the UK rely on the drugs, called GLP-1 receptor agonists, which help regulate hormones and blood sugar levels, cutting the risk of heart attacks and strokes.

But after widespread reporting of recent studies showed one such drug, semaglutide, helped people who take it shed almost a fifth of their weight – regardless of whether they had diabetes or not – demand surged, leading to a global supply problem. The Mail on Sunday was the first newspaper to report on the issue, in November last year.

At present, semaglutide is available in the UK under the brand name Ozempic. The once-a-week self-injection is licensed by UK drug regulators as a diabetes treatment, but doctors are allowed to prescribe it ‘off-label’ – use it in a different way than stated in its licence – to help patients without diabetes lose weight, if they believe it’s justified.

And celebrities including Elon Musk, Jeremy Clarkson and former PM Boris Johnson have all admitted to taking it.

Roughly 400,000 type 2 diabetics in the UK rely on the drugs, called GLP-1 receptor agonists, which help regulate hormones and blood sugar levels, cutting the risk of heart attacks and strokes

Kim Kardashian was also rumoured to have used Ozempic to help her squeeze into her dress for the 2022 Met Gala – the same one Marilyn Monroe wore when she sang Happy Birthday Mr President in 1962

Kim Kardashian was also rumoured to have used Ozempic to help her squeeze into her dress for the 2022 Met Gala – the same one Marilyn Monroe wore when she sang Happy Birthday Mr President in 1962. Although Ms Kardashian has never confirmed this, the story was widely circulated on social media and further fuelled demand for the drug.

Another drug containing semaglutide, known by the brand name Wegovy, has been licensed for weight loss in patients who don’t have diabetes, but this is yet to be launched in the UK.

There are other GLP-1 drugs that work in a similar way, but shortages are now reportedly affecting all types of the drug, and semaglutide manufacturer Novo Nordisk say stock issues will continue until mid-2024.

In a bid to manage the situation, the Government’s Medicines and Healthcare Products Regulatory Agency (MHRA) this month issued a patient safety alert to all doctors and pharmacists, effectively ordering them not to prescribe semaglutide for weight loss alone.

‘Use of these agents for the management of obesity is strongly discouraged,’ it said, adding: ‘Existing stock must be conserved for use in patients with diabetes.’

Despite this, The Mail on Sunday has discovered online pharmacists still offering semaglutide as a diet aid to obese patients, costing from £230 for a one-month supply. While there is no suggestion what they are doing is unlawful, in response, one high profile GP has called for a halt to all private sales of the drug for weight loss.

And London-based endocrinologist Professor Barbara McGowan says: ‘It’s a difficult situation. People are often desperate for treatment for obesity, which can cause a range of health problems, not just diabetes.

‘Semaglutide is an effective treatment [which leads to weight loss]. But while there are supply issues, patients with the greatest clinical need should be prioritised.’

As we have discovered, this isn’t what’s happening at present. Two weeks ago, The Mail on Sunday’s GP columnist Dr Ellie Cannon asked readers if they had struggled to get hold of semaglutide – and she received a flurry of emails and letters in response.

Many told of calling and visiting dozens of pharmacies in a frantic and ultimately futile search for Ozempic. Others revealed that they had been forced to self-ration, taking half doses to make their supplies last.

One patient affected by the shortages is Brenda Read, 73, who lives in Sittingbourne, Kent, with husband Barry, 75, and runs an antique business. Brenda was diagnosed with type 2 diabetes in 2008.

She says: ‘Doctors tried a dozen different types of tablets but nothing got my blood sugars down.’

In 2021 she heard about Ozempic from a friend and persuaded her GP to prescribe it. ‘They were reluctant as they said it was expensive,’ she says. ‘But I told them that I pay my taxes and they gave it to me.’

Thanks to Ozempic, Brenda lost four stone over three years. Currently, she is 14st 3lb and, importantly, her blood sugar is well within the healthy range. However, research shows as soon as patients stop taking GLP-1 drugs, they begin to put weight back on and blood sugars rise.

It’s a thought that terrifies Brenda. She says: ‘In June, the GP warned me patients were having problems getting hold of Ozempic. I rang 47 chemists over several days. At least a dozen told me, ‘You’ll never get it because the private doctors are getting in first.’

‘Eventually I was able to get a month’s worth, but that was half my normal dose, and for the last two weeks I’ve had nothing at all.

‘I know someone who is paying £250 a month for Ozempic and she’s watching the weight drop off. It’s all for a family event next year. I can’t afford that and don’t know how this will affect me for the rest of the year. I will probably have to go back on metformin [another commonly given drug for type 2 diabetes] to control my blood sugar, but that caused terrible bladder infections and I have no problems on Ozempic. It makes me so angry.’

Another reader, Carolyn, who asked us not to print her full name, was diagnosed with type 2 diabetes two decades ago, aged 44.

She started on Ozempic in 2020 and says it transformed her health: ‘It had lowered my blood sugars and I lost around two stone. I’ve been without it for several weeks, and in that short time I can feel my appetite increasing.

‘Years ago I was told that if my diabetes wasn’t controlled I had a greater chance of losing limbs, having a heart attack or a stroke. My last annual diabetic eye test showed my vision was deteriorating, so that’s another cause for concern if this drug shortage goes on.’

And retired plumber Michael Fennelly, 75, who lives in Worthing, said: ‘I didn’t lose much weight [on semaglutide] and my appetite didn’t change, but the effect on my blood sugar was almost immediate and has continued.

‘I ran out a week ago and now I’m concerned. I’ve read in the news that the shortages were caused by people obtaining the drug for slimming. How selfish they are when diabetics like me need it for medical reasons.’

Last week we contacted four of the best-known companies offering private prescriptions. Two indicated they would provide Ozempic – despite our reporters clearly stating on online forms that they were obese but did not have diabetes or any other health problem and wished to take the drug simply to lose weight.

After filling out a short questionnaire and paying £279, myBMI.co.uk approved our reporter for a month’s supply of the drug, which it claimed would be delivered within 48 hours.

Manual, a men’s health company that also sells hair loss and erectile dysfunction treatments, charged £230 for an initial one-month supply of semaglutide – then increasing to £299 a month on subscription.

Manual requires a full-length photo and photographic ID in order to verify would-be patients are the weight they claim to be – however messages to our reporter said that once this check was done, Ozempic was in stock and would be supplied.

In each case, we cancelled the orders before any medication could be sent out.

Dr Frank’s Weight Loss clinic took payment of £235, and at no point in the process was our reporter told they could not buy the jabs as they did not have diabetes.

The providers did not respond when we later contacted them for comment, however Dr Frank’s Weight Loss Clinic did subsequently send an email to our reporter saying: ‘We have carefully reviewed your consultation and at this time, we regret to inform you that you have not met the specific criteria to participate in the program.’

The £235 was refunded. Only online men’s health brand Numan, which has previously offered private prescriptions for Ozempic, told us it was not offering the drug due to the Government guidance.

In light of our findings, Dr Philippa Kaye, a GP and vocal advocate of GLP-1 drugs to treat obesity, says: ‘Both diabetes and obesity put patients at risk of things such as cardiovascular disease. However, when there isn’t enough of these medicines to go round, we need to ration according to greatest need.

‘That’s why the MHRA has acted. I would love there to be more of the drugs – but it isn’t right that people without diabetes are able to get Ozempic simply because they can pay for it, while patients with type 2 diabetes are left at risk.

‘Separately, I worry about how easy it is to get these drugs online – as The Mail on Sunday’s investigation has shown.

‘It’s a system that’s open to abuse by people with eating disorders and others who might try to use semaglutide inappropriately.’

Novo Nordisk – Ozempic’s manufacturer, which recorded nearly £7 billion in sales of the drug last year – is said to be planning a £1.8 billion upgrade to its manufacturing facility in a bid to increase its capacity.

A spokesman said: ‘We do not promote, suggest or encourage the off-label use, or misuse of any of our medicines. We are continuing to work with MHRA and the Department of Health and Social Care to monitor the supply of our medicines and to keep healthcare professionals updated so that they can support patients to receive the treatment they need.

‘We are fully aware that demand is high for both [diabetes and obesity] patient populations and are doing everything we can to meet patients’ needs.’

The NHS can prescribe semaglutide for a maximum of two years, but last week experts reiterated that treatment would be expected to be life-long. Speaking to The Mail on Sunday’s Medical Minefield podcast this week, Professor Carel le Roux, an expert in obesity at the University of Ulster, said: ‘We now think of obesity as a neurological disease affecting the areas of the brain that control how much fat the body wants to store.

‘We have medications [such as semaglutide] that work in that exact part of the brain to treat this disease, and bring it under control.

‘But the minute you stop treatment, the disease relapses. We always ask patients, ‘are you prepared to take this treatment for the rest of your life?’ Because if they aren’t, they shouldn’t start.’

He added that obesity should be seen like any other chronic disease.

‘We wouldn’t stop a patient with asthma or high blood pressure from taking medication, and this is no different,’ he said. ‘Not everyone will respond. So if somebody hasn’t lost approximately a stone in the first three months, we might consider stopping treatment and trying something else.

‘And of course, not everyone will want to be on medication.’

All this will come as little comfort to diabetes patients facing the prospect of having to come off the treatment that’s been keeping their condition under control.

As former lab technician Susan Brown, 73, from Maidstone, Kent, says: ‘It’s over a month since I’ve had any Ozempic to take for my diabetes, and my blood sugar levels have become far less stable.

‘I feel really shaky and sweaty, especially in the morning. I carry around my prescription, so that I can present it whenever I pass a chemist, but none have had it.

‘The GP says I will need an alt- ernative, so that worries me. In the meantime, I dread how washed out and unsteady I’m now feeling.’

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