‘Vital’ to improve diabetes medication supply and staff resource before winter

Pressure on primary care teams, including the impact of diabetes medication shortages, is preventing diabetes patients from receiving the recommended routine care they expect, a UK diabetes charity has warned.

Diabetes UK also called for medication supply to be ‘drastically improved’ and staff resource to be increased before the winter, when NHS resources will come under even more strain.

The charity also said that diabetes should have been given greater prominence in the government’s interim report on its major conditions strategy, which was published earlier this week, given the disease’s contribution to cardiovascular disease.

Douglas Twenefour, head of care at Diabetes UK, told The Pharmacist that ongoing shortages of GLP-1 medications, including Ozempic, were having ‘serious implications’ for many people with type 2 diabetes and were a ‘major concern’.

He said: ‘The situation is causing considerable stress and uncertainty for those affected and, in cases where no other alternatives are suitable, people are being moved on to insulin – which can be challenging to manage and requires additional time from healthcare professionals to support people to use it.’

The charity welcomed the Government’s guidance to prescribers that glucagon-like peptide receptor agonists (GLP-1 RAs) should not be prescribed off-label during the shortage, in order to conserve existing stock for people with type 2 diabetes.

And Mr Twenefour said that it was ‘vital that the supply of these medications into the NHS is drastically improved before the winter, when NHS resources come under even more strain.’

‘We also want to see an increase in staff resource, to ensure there is greater support for people impacted by this issue and to safeguard against any further impact on routine diabetes care,’ he added.

In a statement published today, the charity warned that delivery of routine care for diabetes patients had still not recovered to pre-pandemic levels.

And it said that recovery had been ‘hampered by the various pressures on primary care and diabetes teams’, including the recent shortages of glucagon-like peptide receptor agonists (GLP-1 RAs).

These medication shortages were ‘leading to some people not being optimally managed and staff time being spent on reviewing people affected by the shortages’, Diabetes UK said.

And a failure to provide routine care would significantly increase the risk of emergency admissions, heart failure, amputations, renal replacement therapy, sight loss and early death, the charity said.

Diabetes UK said that improving care for people with diabetes should have been featured more prominently in the government’s plans to prevent ill health, ‘recognising it as such a significant underlying factor for so much harm including heart disease and stroke.’

The interim report was also ‘generally quite light’ on plans to tackle health inequalities, despite the government’s promise that the major conditions strategy would replace in part the planned ‘health disparities’ strategy, Diabetes UK added.

And it said it was surprised that the interim report made no reference to the need for local health systems to improve timely diagnosis of type 2 diabetes, citing recent evidence that suggests a delayed diagnosis and delay in receiving care.

Last month, The Pharmacist reported on the impact of GLP-1 RA shortages on practice team and community pharmacy workload, highlighting concerns about knock-on insulin shortages and patient care.

Shortages of GLP-1 receptor agonists are expected to continue for at least the next year, with the Department of Health and Social Care (DHSC) citing supply issues caused by an increase in demand for licensed and off-label indications.

Novo Nordisk, which manufactures GLP-1 RA medications Ozempic and Wegovy, told The Pharmacist that it is experiencing ‘intermittent supply constraints for its GLP-1 RA medicines for people living with type 2 diabetes in the UK’ due to ‘unprecedented levels of demand’.

A spokesperson added: ‘We are acutely aware of the uncertainty and concern this is causing, and the disruption patients and healthcare professionals are experiencing.’

And they said that the manufacturer is working closely with the Medicines and Healthcare Regulatory Agency (MHRA) and was doing its ‘utmost’ to discourage the off-label use of its medicines.

‘We are working together to issue communications about the appropriate use of our medicines at this time to healthcare professionals. We do not promote, suggest, or encourage the off-label use, or misuse of any of our medicines,’ the spokesperson said,

The government has been approached for its response to Diabetes UK’s comments.