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Nurses warned about ongoing shortage of diabetes drugs

The shortage of a class of diabetes medicines that is leaving some patients without access to their recommended treatment is likely to last until the end of 2024, nurses have been warned.

GLP-1 receptor agonist medications are prescribed on the NHS for lowering blood glucose levels in patients with type 2 diabetes.

“The ongoing shortages of many GLP-1 medications are having serious implications for many people with type 2 diabetes”

Douglas Twenefour

However, a rise in off-label use of the injectable GLP-1 medication Ozempic for weight loss has contributed to a global demand for this treatment that has outstripped supply.

The knock-on effect of the shortage of Ozempic is that other injectable GLP-1 medicines are now also in short supply, leaving prescribers and diabetes patients across the UK without access to these treatments.

In a statement released this week, the Nursing and Midwifery Council highlighted the need for nurses to be aware of latest guidance on how to manage this shortage of GLP-1 receptor agonist medications.

A national patient safety alert on the GLP-1 shortage from the Department of Health and Social Care and NHS England, published earlier this month, said that the “supply of glucagon-like peptide-1 receptor agonists (GLP-1 RAs) continue to be limited, with supply not expected to return to normal until at least the end of 2024”.

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It also said not to prescribe GLP-1 medications licensed for type 2 diabetes for off-label indications because “existing stock must be conserved for patients with [type 2 diabetes mellitus] to mitigate the risk of impaired access to treatment and increased risk in diabetes related complications”.

The alert outlined an updated list of actions for clinicians and prescribers of GLP-1 medications that are to be completed as soon as possible and not later than 28 March 2024, and provided advice on what to do if certain drugs are unavailable.

Paula Johnston, lead diabetes inpatient specialist nurse (DISN) at Southampton General Hospital and vice chair of the national DISN UK Group, said that the GLP-1 shortage had caused “increased pressure” on healthcare professionals.

She said that a lot had been done behind the scenes to ensure that, where possible, stocks of GLP-1 RAs were available for existing patients, so they have been able to continue on their treatment.

But she added that there had been “a considerable amount of work in reviewing treatment options for patients who are not able to continue their GLP-1 RA”.

Ms Johnston told Nursing Times: “Insulin initiation takes a considerable length of time so has caused an increased pressure on healthcare professionals.”

She added that there was now a “significant backlog” of patients awaiting initiation for GLP-1RA therapy.

“The ongoing shortages impact not only the patients but also nursing staff”

Callum Metcafe-O’Shea

Royal College of Nursing professional lead for long-term conditions, Callum Metcafe-O’Shea, said: “For patients with type 2 diabetes, the availability of GLP-1s is essential not in only helping with weight loss but preventing other complications from impacting their health and wellbeing. Shortages are undoubtedly impacting the quality of care they can receive.

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“The ongoing shortages impact not only the patients but also nursing staff as they cannot deliver the care their patients deserve, making treatment failure and the need for specialist services more likely.

“The need to address this shortage comes at a time when the nursing workforce faces many challenges in their practice. Medication shortages on top of this serve further to impact on morale.”

Head of care at Diabetes UK, Douglas Twenefour, said: “The ongoing shortages of many GLP-1 medications are having serious implications for many people with type 2 diabetes and are still a major concern.

“With these shortages likely to last for at least the rest of this year, this will have a significant impact on whether many people with type 2 diabetes can access the best course of treatment for them.

“We fully support the instruction that GLP-1 medications should not be prescribed off-label under any circumstances while there is an ongoing shortage impacting people with type 2 diabetes.”

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