This page was last updated on 4 February 2025.
We have been concerned about the intermittent supply and shortages of glucagon-like peptide receptor agonists (GLP-1 RAs, or GLP-1 analogues), which were having serious implications for many people with type 2 diabetes. These supply issues have now been reported as resolved.
In this guide:
- Why were there supply issues with GLP-1 agonists?
- Prescriptions
- Other effects of stopping GLP-1s
- What did Diabetes UK do?
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.
Why were there supply issues with GLP-1 agonists?
The NHS had been facing supply issues with GLP-1 agonists, 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 was 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.
Stocks were resupplied at the end of December 2024 and this issue has now been reported as resolved.
Prescriptions
Which of my medications are a GLP-1 medication?
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 stopped prescribing my GLP-1 agonist. Why was this?
There are three reasons why you might have been asked to stop your GLP-1 agonist medication:
- Your healthcare professional has reviewed your response to this treatment and feels that it does not help you as intended.
- There may have been supply issues, meaning that your medication was no longer available or out of stock for some time. 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 agonist?
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 are sufficient stocks 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 had been prescribed Byetta injections could be identified and have their treatment changed to Rybelsus tablets. This is because Byetta was discontinued in March 2024.
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 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 agonist soon, 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. And now that the supply issues have been resolved your doctor may still want to start a GLP-1. 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 have supply of my GLP-1 agonist in the fridge, do I keep taking those?
Yes, continue to take your GLP-1 RA medication as normal and try to obtain re-supply as you usually would. You should now be able to obtain re-supply as normal. But if you run out of your GLP-1 RA and you can’t get re-supply as usual, it’s important to discuss this with your healthcare professional.
I have not had any problem obtaining supply of my GLP-1 agonist during the shortage, can I expect to be affected?
If you were established on a GLP-1 RA medication and were not affected by the shortages, then it is likely you will be able to obtain your supplies as normal. You should keep taking your medication as usual but contact your healthcare professional if you run into problems collecting your prescription.
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 run out of your 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 I be affected?
The recommendations during the shortages were that people with type 2 diabetes should be prioritised. We supported 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.
If I stopped my GLP-1 agonist, will I be allowed to restart it now it is available again?
Everyone with diabetes should have a review with their health care professional periodically, and at least once a year. Now supplies are 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 also 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.
Other effects of stopping GLP-1s
Will l gain weight when I stop the GLP-1 agonist?
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 agonist 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.
I drive for a living and have been trying to avoid going on medications that cause hypoglycaemia, can I be prescribed a GLP1 instead?
You should raise any concerns about the impact any new diabetes medication could have on your driving licence with your healthcare professional and they will discuss with you your 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 medication?
If you are concerned about taking more medication or putting on weight with a 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.
What are Diabetes UK doing?
During the shortages we supported the guidance and had ongoing discussions with the manufacturer and the Department for Health and Social Care about our concerns over how this was impacting people with diabetes. If this shortage impacted your mental health and wellbeing you can call the Diabetes UK Helpline – call 0345 123 2399.
