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GP says no to Ozempic or Weegovy

A

Alist33

Member
Relationship to Diabetes
Type 2
Hi I am after some advice, three years ago I was offered a weekly injectable to help manage my Type2 diabetes I was over 20 st and have been diagnosed for 6 years with little success. I didn’t get the meds as Covid hit. Since catching Covid in 2020 I have had a lifestyle change managed to shift 6 st and got fit in the gym eating strict low carb. But then everything has plateaued so I asked my GP for help could I try the injection but they said no use Metformin which I do with very limited effect now I am gaining weight and feeling exhausted but still exercise 4 times a week religiously. Has anyone else had a flat no from their GP? I also have heart failure as a result of Covid 19 and really need to weigh less and control my glucose levels. Any advice welcome Ali
 
Patients can’t be started on these because of the shortage. What is your a1c? There’s criteria to meet to be prescribed these also.
 
Hi I heard of the shortage. Last test was 52 which is not as low as it has been
 
You say strict low carb but how low are you going.
Some people have had success with very low calorie regimes to give them a kick start so that might be an option if the low carb isn't working.
I always though metformin wasn't primarily for weight loss but to help the body use the insulin it is producing more efficiently and stop the liver releasing glucose so more for blood glucose management than weight loss and it is dietary changes that will help with that.
 
I am pretty strict on low carb really only cheat is a few strawberries once a week otherwise I am meticulous. I don’t eat high fat really - mainly chicken and scrambled eggs with salad ( no tomatoes or carrots). I am taking Metformin to control my diabetes. I need to lose more weight to do this. Not sure how some patients get prescribed injections and others don’t. Hence my question. My diagnosis isn’t new but the NICE evidence is.
 
Alist33 said:
Hi I heard of the shortage. Last test was 52 which is not as low as it has been
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You need to look up the criteria for your area but in my area you wouldn’t meet criteria for ozempic even before the shortage as here you need to have tried 3 diabetes meds simultaneously with a high a1c on the 3 diabetes meds and also have bmi above 35
 
Interesting - where would I find the criteria for my area? I have had a good read around and am involved with the NHS myself but not aware of this?
 
Alist33 said:
Interesting - where would I find the criteria for my area? I have had a good read around and am involved with the NHS myself but not aware of this?
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On Google
 
So I take 3 meds currently I have been on Foraxia Metformin and Spiralactone since 2019 and my BMI is 35 so assume I would be eligible but you may know more than I
 
Alist33 said:
So I take 3 meds currently I have been on Foraxia Metformin and Spiralactone since 2019 and my BMI is 35 so assume I would be eligible but you may know more than I
Click to expand...
Spiralactone isn’t a diabetes medication, so you’re only on 2 diabetes tablets at the moment? Forxiga and metformin.

If you lived in my area you’d need to add something like gliclazide first before adding ozempic.
 
Alist33 said:
I am pretty strict on low carb really only cheat is a few strawberries once a week otherwise I am meticulous. I don’t eat high fat really - mainly chicken and scrambled eggs with salad ( no tomatoes or carrots). I am taking Metformin to control my diabetes. I need to lose more weight to do this. Not sure how some patients get prescribed injections and others don’t. Hence my question. My diagnosis isn’t new but the NICE evidence is.
Click to expand...
I wouldn't call having strawberries cheating as berries are something that people find are a very good option for breakfst with full fat Greek yoghurt.
If people are diagnosed with a level of 52 then they are often given the opportunity to reduce it by dietary measures before being prescribed metformin.
I wonder if you are eating a balanced diet and one which is going to be sustainable long term.
This link is a low carb approach which has been successful for people in losing weight so it may give you some new ideas.
lowcarbfreshwell.co.uk

Freshwell Low Carb Project Manual

The Freshwell Low Carb Project Manual written by Dr Kim Andrews. For description, see below. Please allow up to 2 weeks for delivery.
lowcarbfreshwell.co.uk lowcarbfreshwell.co.uk
 
Thank you this is very helpful my HBa1c has been as high as 113 in the past so it has come right down but I am at a point where I can’t seem to get it any lower. I guess I may not be eating enough at the moment
 
Lucyr said:
Spiralactone isn’t a diabetes medication, so you’re only on 2 diabetes tablets at the moment? Forxiga and metformin.

If you lived in my area you’d need to add something like gliclazide first before adding ozempic.
Click to expand...
I was on a gliclazide tablet but they removed it from my prescription when I lost the majority of my weight. Which was a good thing. I also have high BP and take a beta blocker. Ah well I will ask my GP to reconsider my request again. They can only say no I suppose
 
Alist33 said:
I also have high BP and take a beta blocker.
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A beta blocker isn’t a diabetes medication so wouldn’t count as one of the 3 diabetes meds tried simultaneously before adding ozempic, at the moment new patients can’t be started on ozempic anyway because of the shortage.

As I said earlier though, that’s based on the ozempic prescribing guidelines in my area. Use google to find the guidelines for your area.
 
Alist33 said:
Ah well I will ask my GP to reconsider my request again. They can only say no I suppose
Click to expand...

The shortages are making it particularly difficult to access Ozempic/Wegovy at the moment. As @Lucyr says, it’s unlikely new people will be started, and GPs are having to move people away from that class of meds as the prescriptions cannot be filled. :(

The shortages are likely to continue into 2024 I’m afraid

www.diabetes.org.uk

Our response to serious supply issues of drugs for people with type 2 diabetes

UPDATE, 20 MARCH 2024: People in England and Northern Ireland living with type 2 diabetes can now be prescribed Mounjaro as a diabetes treatment, or offered Mounjaro if they are unable to access their usual GLP-1 RA medication. Mounjaro can be prescribed to people living with type 2 diabetes in...
www.diabetes.org.uk www.diabetes.org.uk

What is the latest guidance?​

The new guidance outlines a set of actions for clinicians to follow until the shortages are resolved. These include:

  • Not to prescribe GLP-1 RAs outside of their approved use
  • Avoid starting people with type 2 diabetes on any GLP-1 RAs
  • Not to switch between drug brands or substitute with lower dosages
  • Where alternative treatments need to be considered, discuss and agree a new management plan with those people affected.
The Primary Care Diabetes Society (PCDS) and Association of British Clinical Diabetologists (ABCD) have also produced guidance which recommend supporting eligible people to access weight management and remission services.
 
My DN said I couldn’t go on Ozempic due to the shortages, she hadn’t heard of weegovy, so that was a non starter. She has referred me to an NHS weight loss programme , got to see someone else at the practice tomorrow regarding weight loss and taking Orlistat. My HbA1C is back up to 65, but although overweight I fall just below the BMI 30 benchmark.

If I don’t get anything from NHS I will sign up to the Dr Michael Mosley Fast Keto 800 diet, which Costs £119, although I have a 25% off email. Realise not everyone can afford to pay to sign up.

Hoping you get the help you need.
 
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